Juan Ortiz
Dallas,TX
Summary
Detail-oriented worker with knowledge of account management and collaborating with other departments. Talented at data entry and analysis with exceptional knowledge of Customer Service.
Overview
9
9
years of professional experience
4
4
years of post-secondary education
Work History
Care Coordinator
Collective Health
Plano, TX
11.2023 - Current
- Co-managed patient caseloads effectively with nurses and social workers, ensuring timely follow-up and appropriate interventions.
- Advocated for patients' rights within the healthcare system, working diligently to address concerns or barriers to care.
- Assessed patient needs and connected them with appropriate resources to ensure optimal health outcomes.
- Educated patients on self-care strategies, promoting independence and empowering them to manage their health conditions.
- Ensured compliance with healthcare regulations and standards, maintaining patient safety and confidentiality.
Insurance Verification Operations Supervisor
KidsCare Home Health
Dallas, TX
11.2022 - 10.2023
- Correspond with families/therapists to provide authorization updates as needed.
- Be able to communicate with a caregiver regarding insurance concerns
- Assist with answering telephone calls and sourcing to the appropriate department/employee.
- Monitor all workflows, including authorization workflow.
- Motivate and train employees to maximize team productivity.
- Participate in proactive team efforts to achieve departmental & company goals.
Lead Authorization Coordinator
KidsCare Home Health
05.2021 - 11.2022
- Maintain communication with manager and other departments to ensure consistent and up to date workflow
- Mediate consistent communication between auth manager and team such as relaying important information on changes, issues that arise, and new ideas to enhance team success
- Address incoming phone calls from families or therapists as well as contacting payors or providers for authorization/approval
- Ensure compliance with HIPPA, procedures and working to achieve company goals
Authorization Coordinator
KidsCare Home Health
04.2019 - 05.2021
- Request and obtain prior authorization for new and existing clients
- Communicate with insurance carriers in order to complete patient prior authorization
- Coordinate with therapist and clinical managers to finalize visits for patients
- Follow up via phone/ email relevant to inactive insurance, inform families and therapists
Insurance Coordinator/Pharmacy Representative
DaVita Rx
07.2016 - 09.2018
- Effectively communicated relationships between patients, pharmacies, insurance companies, and doctors' offices
- Processed medications to ensure patients received their drug therapy in a timely manner
- Advised patients daily regarding their insurance status by verifying insurance coverage and eligibility
- Recognized for consistently maintaining and exceeding expected productivity goals
Education
High School Diploma -
Sunset High School
Dallas, TX 08.2007 - 05.2011
Skills
Customer Relations
Bilingual in English and Spanish
Organization and Time Management
Self-Motivated
Timeline
Care Coordinator
Collective Health
11.2023 - Current
Insurance Verification Operations Supervisor
KidsCare Home Health
11.2022 - 10.2023
Lead Authorization Coordinator
KidsCare Home Health
05.2021 - 11.2022
Authorization Coordinator
KidsCare Home Health
04.2019 - 05.2021
Insurance Coordinator/Pharmacy Representative
DaVita Rx
07.2016 - 09.2018
High School Diploma -
Sunset High School
08.2007 - 05.2011
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