Jackelin Caraballo
Sedro Woolley
Summary
Organized Patient Service Representative with 22 years of experience in healthcare. Adept at patient advocacy and education with commitment to efficiency. Skilled at coordinating busy offices and maintaining professionalism in stressful situations.
Overview
26
26
years of professional experience
Work History
Insurance Authorization Specialist
Skagit Regional Health
Mount Vernon
10.2023 - Current
- Managed daily workflow related to obtaining authorizations from various health plans including Medicare and Medicaid and commercial carriers.
- Reviewed and processed prior authorization requests for medical procedures and medications according to established guidelines.
- Communicated authorization decisions, including approvals and denials, to healthcare providers and patients.
- Maintained accurate and up-to-date records of authorization requests and outcomes in electronic health record systems.
- Verified insurance eligibility for patients and entered information into the system.
Patient Service Representative
Skagit Regional Health
Mount Vernon
09.2020 - Current
- Operated standard office software applications to compile data and prepare information and correspondence.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Followed document protocols to safeguard confidentiality of patient records.
Customer Service Representative and Water Fitness Instructor
Riverside Health Club
Mount Vernon
05.2017 - Current
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Updated account information to maintain member records.
- Recorded account information to open new memberships.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Scheduled swim lessons
- Sent out monthly statements and billing reports to partner companies.
Barista Trainer
Starbucks
Burlington
06.2016 - 11.2017
- Customized training strategies based on individual barista knowledge, experience and strengths.
- Learned new drinks and procedures first, and instructed all team members on how to properly complete each.
- Repaired minor issues and maintained espresso equipment and coffee machines for smooth functioning.
- Handled cash and processed payments accurately to avoid errors.
- Restocked display cases with attractive arrangements to promote specialty food items like bagels and muffins.
- Taught proper procedures and strategies for success to new employees.
- Pleasantly interacted with customers during hectic periods to promote fun, positive environment.
- Controlled line and crowd with quick, efficient service.
Patient Service Representative
Peace Health Cancer Center
Bellingham
07.2005 - 06.2016
- Accurately schedule patient chemotherapy calendars, doctor appointments and imaging appointments.
- Reconciled patient charts for referrals to outside facilities.
- Code and enter charges for infusion nursing visits.
- Super user and trainer for EPIC and other software programs.
- Maintained daily nursing schedules for infusion department.
Mammography Data Coordinator
H. Lee Moffitt Cancer Center
Tampa
09.1999 - 06.2005
- Responsible for triage and scheduling patients for biopsies and other radiological procedures.
- Collected pertinent external records and imaging films.
- Gathered complete documentation for weekly medical conferences.
Education
High School Diploma -
Tampa Bay Technical High School
Tampa, FL06.2005
Associate In Arts -
Hillsborough Community College
Tampa, FLSustainable Resource Management -
Arizona State University
Tempe, AZSkills
- Interpreting Physician Orders
- Appointment Scheduling
- Payment Collection
- Patient Checkout Procedures
- Insurance verification
- Prior authorization
- Medical terminology
- Problem solving
Timeline
Insurance Authorization Specialist
Skagit Regional Health
10.2023 - Current
Patient Service Representative
Skagit Regional Health
09.2020 - Current
Customer Service Representative and Water Fitness Instructor
Riverside Health Club
05.2017 - Current
Barista Trainer
Starbucks
06.2016 - 11.2017
Patient Service Representative
Peace Health Cancer Center
07.2005 - 06.2016
Mammography Data Coordinator
H. Lee Moffitt Cancer Center
09.1999 - 06.2005
High School Diploma -
Tampa Bay Technical High School
Associate In Arts -
Hillsborough Community College
Sustainable Resource Management -
Arizona State University