Jenny Santana
Senior Member Advocate
Lakeland,FL
Summary
Capable senior member advocate dedicated to providing superior support regarding insurance coverage, finance options and documentation requirements. Well-versed in scheduling and database management functions for streamlined communication and reduced correspondence backlogs. Excels at identifying client needs and concerns to improve engagement strategies and overall service. Resourceful Patient Advocate offering 10 years of hospital experience. Versed in collaborating with insurance companies and completing paperwork. Passionate about patient care.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Senior Member Advocate
Zelis Healthcare
St. Petersburg, FL
04.2022 - Current
- Used mediation techniques to facilitate communication between disputants, to further parties' understanding of different perspectives and to guide parties toward mutual agreement.
- Drove dispute resolutions using effective problem-solving and by guiding mutual understanding of opposing viewpoints.
- Facilitated and implemented settlement agreements by proposing resolutions and supporting effective decision-making for involved parties.
- Prepared written opinions or decisions regarding cases.
- Drafted settlement paperwork and gathered signatures from disputants to provide official documentation of agreed-upon solutions.
- Reviewed and analyzed opposing sides of disputes to objectively assess situations from legal perspective.
- Used Microsoft Word and other software tools to create documents and other communications.
- Worked effectively with staff from all departments to coordinate resolutions.
- Assisted patients in understanding individual rights and responsibilities in regards to care, coverage, and payment.
- Advocated for patient rights and access to support resources in healthcare settings.
Insurance Verification Specialist
Surgery Center Of Lakeland Hills Blvd
Lakeland , FL
11.2020 - 04.2022
- Determined appropriateness of payers to protect organization and minimize risk.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Posted payments to accounts and maintained records.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Reviewed 150 patient cases per week and verified insurance coverage information.
- Verified client information by analyzing existing evidence on file.
- Observed strict procedures to protect sensitive patient information, medical records and payment data.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Facilitated organized record retrieval and access by maintaining filing system for both in-house and discharged residents.
- Contacted hospitals to confirm patients medical histories and prevent inaccurate diagnoses and treatments.
- Managed financial documentations such as expense reports and invoices.
- Managed office logistics by scheduling appointments, maintaining files and collecting payments.
Exercise Specialist
Watson Clinic
Lakeland, FL
09.2018 - 11.2020
- Effectively monitor patient activity and communicate with therapist and patients regarding both concerns and progress.
- Review patient status by referring to chart and direct communication with treating therapist on daily basis.
- Maintain physical environment of center and ensure state of readiness to provide patient care.
- Maintain all department supplies at proper stock levels and in appropriate locations.
- Complete clerical activities as requested, accurately and in timely fashion.
- Coached and demonstrated proper exercise techniques, achieving commendations for motivational approach to fitness.
- Established safe, productive and encouraging workout environment.
- Explained exercise modifications and contraindicated movements to participants with history of injury.
- Coached and demonstrated proper exercise techniques, achieving commendations for motivational approach to fitness
- Assessed fitness levels before and after completion of individualized exercise programs, implementing changes to expedite results
- Established safe, productive and encouraging workout environment
- Explained exercise modifications and contraindicated movements to participants with history of injury
Referral Coordinator
IMA Medical Group
Lakeland, FL
07.2017 - 09.2018
- Maintain list of all preferred specialist and ancillary providers
- Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process
- Weighed patient need, provider availability and insurance coverage to determine optimal scheduling
- Linked families to relevant community support to meet non-medical needs
- Collected and verified completeness of intake and enrollment screening packets for facility
- Called insurance companies to get precertification and other benefits information on behalf of patients
- Trained 2 staff on referral and intake process
- Coordinated with medical staff and patients to find cost-effective options for services
- Followed up with clients and specialists to inquire about experience and collect reports
Independent Contractor
Communication Company, Home Based
Lakeland, FL
09.2014 - 07.2017
- Receive inbound calls from customers looking to make purchase.
- Assist customers with product already purchased.
- Identifying customers need and providing appropriate steps.
- Assuring each customer interaction is Memorable, Customized and Relevant.
- Meeting/Exceeding Client Metrics.
- Evaluated consistency and importance of different business intelligence data against needs to determine optimal courses of action
- Developed effective improvement plans in 2015
- Delivered outstanding service to customers to maintain and extend relationships for future business opportunities
- Collaborated closely with clients to better understand entire project scope
- Set, enforced and optimized internal policies to maintain responsiveness to demands
Scheduling Coordinator
Midtown Dental
Lakeland, FL
04.2012 - 08.2014
- Answer incoming calls using proper telephone etiquette.
- Coordinate and schedule meetings, conferences and business travel.
- Greet and check in patients in professional and friendly manner.
- Oversee patient appointments and scheduling of all staff doctors Schedule.
- Reschedule and confirm new patient appointments.
- Work to maintain full schedules and maintain office schedule flow.
- Collect co-payments and verify insurance coverage as appropriate.
- Prepares, reconciles and tracks expense reports for reimbursement.
- Perform all necessary paperwork.
- Oversee dental office expenditures/budgeting and profit margins.
- Scheduled procedures, surgeries and doctor appointments for average of 50 patients per daily
- Led team of 3 scheduling coordinators
- Addressed internal supply problems head-on and developed creative solutions to prevent delays and missed targets
- Developed and implemented scheduling policies
- Reviewed production specifications
Education
Associates Degree - Liberal Arts
Nassau Community College
Garden City, NY 01.2003 - 1 2005
High school Diploma - undefined
Uniondale High School
Uniondale, NY 01.1999 - 1 2002
Skills
Insurance coverage verification
undefinedAffiliations
Personal Trainer – International Sports Sciences Associations -
Transformational Specialist – International Sports Sciences Associations -
Sports Nutrition – International Sports Sciences Associations -
CPR– International Sports Sciences Associations
Certification
First Aid/CPR Certified
Timeline
Senior Member Advocate
Zelis Healthcare
04.2022 - Current
First Aid/CPR Certified
10-2021
Insurance Verification Specialist
Surgery Center Of Lakeland Hills Blvd
11.2020 - 04.2022
Exercise Specialist
Watson Clinic
09.2018 - 11.2020
Referral Coordinator
IMA Medical Group
07.2017 - 09.2018
Independent Contractor
Communication Company, Home Based
09.2014 - 07.2017
Scheduling Coordinator
Midtown Dental
04.2012 - 08.2014
Associates Degree - Liberal Arts
Nassau Community College
01.2003 - 1 2005
High school Diploma - undefined
Uniondale High School
01.1999 - 1 2002