Jasmin Martinez
Springfield,MA
Summary
Reliable professional offering an extensive career promoting positive customer experiences. Sharp Eligibility Specialist boasting expertise in managing and eligibility information for members and groups.
Overview
15
15
years of professional experience
Work History
Service Authorization Specialist/Medical Interpreter
Commonwealth Care Alliance
Springfield, MA
11.2021 - Current
- Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
- Ensured timely submission of accurate documentation to support payment of services rendered by providers.
- Reviewed applications to verify client information and resolve discrepancies.
- Determined resources required to achieve successful software conversion and validation upgrade.
- Attended continuing education seminars on topics relevant to the role such as coding changes or insurance policy updates.
- Researched patient eligibility, coverage information, and benefit levels.
- Explained reasons behind application denials and recommended further action.
- Investigated discrepancies identified during audits of claims submitted for reimbursement by providers.
- Processed prior authorization requests in accordance with departmental guidelines.
- Generated monthly reports detailing productivity metrics such as number of authorizations processed per day, week, month.
- Participated in new hire training and development tasks.
Patient Care Coordinator
HearingLife
Chicopee, Massachusetts
10.2016 - 11.2021
- Screened patients for eligibility for state, local and federal assistance programs.
- Completed insurance verifications and claim forms for patient intake and processing.
- Coordinated patient care services with the medical team to ensure quality and timely delivery of care.
- Coordinated with insurance companies to confirm patient coverage and process claims.
- Cultivated positive relationships with patients to help facility meet satisfaction scores and patients obtain best possible care.
- Instructed patients on policies and required actions for different types of appointments and procedures.
- Developed and implemented patient care policies and procedures to improve service quality.
- Provided administrative support for patient care staff.
- Collaborated with multidisciplinary teams in order to provide comprehensive patient centered care.
- Organized timely and accurate referrals to help patients obtain health care services and access available resources.
- Assisted physicians in performing various procedures related to patient care needs.
Personal Care Assistant
Tempus Unlimited
Chicopee, MA
01.2010 - 10.2018
- Built strong and trusting rapport with clients and loved ones.
- Aided with mobility and independence for disabled individuals and continually monitored safety.
- Made beds, swept floors and sanitized surfaces to support activities of daily living.
- Coordinated patient care plans with doctors and registered nurses and communicated treatment steps to patients.
- Reported any observed changes in mental status or physical condition to supervisor immediately.
- Coordinated doctor appointments, exercise, recreation, and family visits to maintain schedule.
- Researched community resources available for additional assistance or services if needed.
Education
Certificate - Medical Interpreter
Springfield Technical Community College
Springfield, MA01-2019
Certificate - Cosmetology
Jolie Beauty Academy
Ludlow, MA03-2009
Skills
- Prior authorization
- Patient eligibility
- Insurance verification
- Claims processing
- Documentation accuracy
- Regulatory compliance
- Documentation and reporting
- Team training
- Proficient in Spanish/ Medical Terminology
- Analytical thinking
- Multitasking Abilities
- Teamwork and collaboration
Accomplishments
- Community Organizer Volunteer
- Raised money for cancer and donated haircuts
- Exceeds targets as a Informal Team Lead
Timeline
Service Authorization Specialist/Medical Interpreter
Commonwealth Care Alliance
11.2021 - Current
Patient Care Coordinator
HearingLife
10.2016 - 11.2021
Personal Care Assistant
Tempus Unlimited
01.2010 - 10.2018
Certificate - Medical Interpreter
Springfield Technical Community College
Certificate - Cosmetology
Jolie Beauty Academy