Jason Lopez
North Hollywood,CA
Summary
I am highly motivated, ambitious, and demonstrate the ability of handling various job duties in a detailed organized manner. I am an excellent team player with strong communication, customer service and management skills. I am reliable, trustworthy, and consistently perform to the best of my ability. A fast learner makes me capable to handle my position as well as being able to grow with the company to allow further advancement and additional responsibilities. Exceptional and intuitive interpersonal skills gifted focused listener, highly attentive to consumer needs Demonstrated strengths in championing products, researching competition Keen ability to explain technical or complicated issues in a comprehensive manner Dedicated to growing bottom-line revenues while ensuring the highest levels of service.
Overview
16
16
years of professional experience
Work History
Medical Office Representative
Medix Staffing
04.2023 - 10.2023
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Managed multi-line phone system and pleasantly greeted patients.
- Checked patient insurance, demographic, and health history to keep information current.
- Helped patients complete necessary medical forms and documentation.
- Maintained current and accurate medical records for patients.
- Supported office staff and operational requirements with administrative tasks.
- Transcribed phone messages and relayed to appropriate personnel.
- Completed patient referrals to other medical specialists.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Performed various administrative tasks by filing, copying and faxing documents.
- Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
Provider Operations Network
MedPointManagement
08.2021 - 03.2023
- As an In-House IPA Client Representative, my daily job duties and responsibilities would be to account for all or any health plan model of care documents, new provider training documents, collect W-9 forms, verify DHCS proof, and verify that provider licenses were up to date through the department of consumer affairs
- A lot of these tasks required for me to constantly initiate outbound calls to multiple provider offices if anything was ever unaccounted for
- I also would send and receive a high volume of emails on a daily basis in order to meet company standards and succeed in my role as in In House IPA representative
- As an IPA representative I, was responsible for activating pending specialist and Mid-Level providers with our IPA, by sending activation notification packages to each health plan that was contracted with my specific IPA, which was (Global Care Medical Group) Aside from activations, I also would send health plan notifications for the provider's practice location updates, demographic updates, closed / open panel updates, and termination notifications
- In conjunction with all my responsibilities and job duties, I was also part of the support team for our PNO provider phone queue
- Most of our calls included the Drs
- Offices calling in to verify of they were in or out of network with the medical group.
Client Support Center
MedPoint Management
11.2020 - 08.2021
- Client support representative, in an inbound call center
- My daily tasks, include assisting provider and health plan representatives, to verify authorization statuses through EZ cap, and verifying authorization details such as CPT codes and Diagnosis codes
- I also assist frequently in redirecting authorizations, adding or modify CPT codes along with diagnosis codes
- Sometimes I lay assist a provider in verifying LOAs or sending emails directly to the IPA and management to begin an LOA for a member
- As part of my duties, I work very closely, with the leads and department supervisor on a daily basis in order to assist providers with anything that they in regard to members authorizations
- I'm an excellent team member and work exceptionally well with my other teammates
- I'm have great communication skills, which always helps me achieve my tasks or goals in my department
- Being in this department has expanded my knowledge within healthcare insurance business.
Customer service representative
Regal Medical Group
01.2018 - 10.2020
- Customer service representative, in a fast pace inbound / outbound call center for IPA group
- Part of my job description include, HIPAA, verifying member eligibility, authorization status along with details through EZ cap system, also assisting members with authorization redirects along with following up with the member regarding a resolution to another provider or facility
- Also, as part of member service department we are tasked with verifying member claim statuses, to health plans and member's regarding whether they have been approved or denied
- A member service is also tasked with providing any additional information a member may need from providing their doctor's contact information to locating urgent cares and nearby hospitals
- As part of member services we work closely with the upper management team in order to provide an excellent customer service experience for our member's, and to meet company and department goals and standards.
Customer service representative
Health Net
03.2017 - 12.2017
- Customer service representative at inbound / outbound call center
- Assisted California Medi-Cal members with basic general customer service issues
- As part of the Medi - Cal member service department we were tasked in working closely and diligently with our upper management to achieve department and company goals, to assist our members, meet their medical needs
- Duties included verifying benefits, and eligibility, authorizations, claims, initiating appeals and grievances
- Also assigning members to primary care physician, and medical group
- Part of that responsibility was to make outbound call to the PCP office and verify if they have open panel
- Company standard was quality over quantity in our department and I strived to achieve the upmost quality service for our members.
Customer Service, Cashier, Stocker
Costco
07.2007 - 04.2012
- My main job duties which was always priority, was providing quality
- I worked closely with upper management to coordinate sales and customer satisfaction as part of a membership warehouse.
Education
High School Diploma -
Granada Hills Charter High School
06.2005
Skills
- HIPAA Compliance
- Referral Verification
- Bilingual/Spanish
- Eligibility Verification
- Knowledge in Medical Terminology
- Appointment Scheduling
- Professional Telephone Etiquette
- Detail Oriented
- Multi-telephone System
- REA Portal
- EZ Cap
- Epic Systems
- Move Docs Portal
Timeline
Medical Office Representative
Medix Staffing
04.2023 - 10.2023
Provider Operations Network
MedPointManagement
08.2021 - 03.2023
Client Support Center
MedPoint Management
11.2020 - 08.2021
Customer service representative
Regal Medical Group
01.2018 - 10.2020
Customer service representative
Health Net
03.2017 - 12.2017
Customer Service, Cashier, Stocker
Costco
07.2007 - 04.2012
High School Diploma -
Granada Hills Charter High School
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