Judith De La Torre
Thornton,CO
Summary
Self-motivated development professional well-versed in individual, corporate and foundation fundraising techniques. Excellent track record of managing donor relationships and identifying new partnerships to increase fundraising support. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
19
19
years of professional experience
Work History
Patient Access Specialist
University Of Colorado Hospital
09.2023 - Current
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
- Collected and validated patient demographics and insurance information.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Obtained signatures from financial responsibility and treatment procedures from patients or guardians.
- Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Prepared patient identification band and completed admissions papers.
- Performed patient pre-admission, admission, transfer and discharge activities.
- Contacted insurance companies for patient medical billing operations.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Providing excellent customer service by promptly answering patient inquiries.
Credentialing Specialist
Optum
04.2022 - Current
- Intake credentialing application review for completion and supporting documentation
- Process name and address changes
- Process initial credentialing and recredentialing applications following policy and procedures
- Process status changes following policy and procedures
- Perform primary source verifications (PSV) from various online sources according to the definition of primary source
- Assist practitioners with CAQH updates and re‐attestations
- Data entry and maintenance into credentialing database in accordance with internal policies and procedures
- Communicate with Credentialing Committee Members, Credentialing Chair, and Chief Medical Officer (CMO)
- Participate with Credentialing Committee Meetings and support each file presented
- Prepare the minutes for each file presented at the Credentialing Committee Meeting
- Provide feedback to reduce errors and improve processes
- Monitor professional licensure, DEA Registrations, CDS, Prescriptive Authority, Board Certifications, etc
- For expiration and sanctions on an ongoing basis
- Provide continuous monitoring of OIG/SAM/NPDB sanctions
- Support Provider Enrollment team efforts
- Develop and maintain relationships with market leadership of various levels
- Anticipate customer needs and proactively identify solutions
- Independently and as a team solve complex problems
- Mentor Credentialing Representatives to grow into the Senior roles
- Undergo delegation and internal audits
- Other duties as assigned.
- Prepared records for site visits and file audits.
- Conducted primary source verifications such as background checks and board certifications.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Received and evaluated applications to look for missing and inaccurate information.
- Enrolled providers and Medicaid, Medicare and private insurance plans.
- Improved organizational filing systems for confidential employee records, resulting in improved accessibility and efficiency.
- Coordinated implementation of people-related services, policies and programs through departmental staff.
Grants Award Specialist
University of Colorado | Anschutz Medical Campus
11.2020 - 09.2021
- Review notice of grant award with Principal Investigator to make note of any special restriction
- Confirm budget information is set up according to approved sponsored budget
- Establish subcontracts as per notice of grant awards with participating institutions
- Facilitate the submission and payment of invoices in a timely manner
- Notify Principal Investigator of any contractual issues or potential problems
- Work with Principal Investigator proactively to establish correct funding and effort for personnel for each sponsored project
- Review funding distribution monthly to ensure there are no gaps in funding, while minimizing the need for retro payroll expense transfers
- Make all necessary funding changes each month per payroll deadlines
- Contact sponsors regarding re-budgeting requested, carry-forward request
- Work with the Office of Grants and Contracts regarding late payment and or late invoicing
- Prepare and reconcile Federal Financial Reports and Final Expenditure Reports before submission to the Office of Grants and Contracts for submission to sponsor.
- Managed grant policy formulation, interpretations and administration.
- Guided administrative aspects of partnership agreements.
- Monitored and analyzed changing laws, regulations and policies pertaining to grants.
- Distributed grant requests for proposals, reviewed responses and recommended acceptance.
- Coordinated events to encourage community involvement and increase awareness of organization's mission.
- Planned and implemented fundraising events.
- Attended events to develop professional network of potential donors.
- Managed budgets for events and campaigns, keeping financial goals on track.
- Skilled at working independently and collaboratively in a team environment.
- Self-motivated, with a strong sense of personal responsibility.
Fiscal Tech (Accounting Technician II)
University of Colorado | Anschutz Medical Campus
02.2019 - 11.2020
- Prepare and submit journal entries and funding distribution entries
- Assists with purchase orders requisitions, vendor setup and payment tracking
- Maintains accounting records and files
- Handles procurement for administrative team
- Oversees sponsored project subcontract activity (set-up, invoicing tracking and payment processing)
- Advisor to faculty regarding EPER submission
- Assists with payroll transactions, including time entry and leave reporting
- Calculates and processes incentive payments
- Responds to a range of inquiries regarding financial transaction; researches and resolves problems
- Assist in audit activities
- Handles annual space inventory survey
- Administrative support activities such as travel planning and reimbursements, setting up complex meetings, assist with credentialing and licensing
- Back up for expense reimbursement processing
- Assists in monthly preparation and distribution of financial reports
- Review and approves Marketplace shopping carts
- Assist with creation of expense reports and assistance of expense report reconciliation
- Post award administration to include, maintaining reporting tools to forecast funding and expenditures per PI
- Compose spreadsheet applications, prepare financial data for into finance and HCM systems
- Analyze, reconcile, balances, and manage accounting records.
- Operated computers programmed with accounting software to record, store and analyze information.
- Checked figures, postings and documents for correct entry, mathematical accuracy and proper codes.
- Maintained, organized and stocked teller window areas.
- Examined financial statements and records to collect important details and verify calculations.
- Trained new tellers in processes and procedures for financial institution, answering questions and providing guidance.
- Prepared bank deposits by compiling data from cashiers, verifying and balancing receipts and sending payment to banks.
- Monitored transactions and customer behavior to identify signs of fraud.
- Proven ability to learn quickly and adapt to new situations.
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Managed time efficiently in order to complete all tasks within deadlines.
- Proved successful working within tight deadlines and a fast-paced environment.
- Strengthened communication skills through regular interactions with others.
Finance and Research Manager
University of Colorado Bioengineering Department
09.2016 - 02.2019
- Generate and analyze University of Colorado m-Fin financial reports and Children's Hospital Colorado Operating and restricted fund reports, along with various reports available in other software/database programs
- Reconcile month-end revenue and expense documentation and accounts for multiple financial systems, including Children's Hospital (CHCO), CU Medicine, and University of Colorado Anschutz Medical Campus (UCAMC)
- Establish and maintain effective internal controls for finance, grants and contract administration to monitor revenue and expenditure activity for each source of funds
- Responds to requests for information, research financial data, troubleshoot and correct discrepancies, and incorporate feedback to ensure accurate financial reporting
- Develop and maintain spreadsheets, databases, maintain reporting tools to forecast funding and spending per Principal Investigator, lab or other cohort
- Responsible for ensuring section non-patient receivables are collected and properly deposited
- Assist with annual budget proposals and other financial analyses as requested
- Work collaboratively with Grants Coordinator to help manage the post-award workload and responsibilities, including financial reporting or the division, reviewing funding terms and conditions, identify unforeseen changes from initial submission
- Pre-award grant administration, prepare application for sponsoring agency, including budget and technical sections of the application
- Work closely with Department and Section and grant start, end and renewal dates as well as all report submission deadlines
- Meet with Principal Investigator to address funding cuts, consider or modify the proposed research since the initial submission
- Regularly review and update Principal Investigator.
- Developed relationships and communicated with clients to explain proposals, present research findings or discuss project status.
- Maintained budget guidelines, approved all expenses and submitted timely financial reports.
- Planned or directed research, development or production activities.
- Built and strengthened field partnerships to advance group research and awareness of activities.
- Developed and implemented plans and protocols for ongoing research, special projects and testing protocols.
- Investigated, compiled and modeled information for detailed project proposals.
- Evaluated team member work for quality, ethics and compliance with project specifications.
- Self-motivated, with a strong sense of personal responsibility.
- Skilled at working independently and collaboratively in a team environment.
- Conveyed technical information in easily understood terms for non-technical individuals.
- Conferred with scientists, engineers and regulators to plan or review projects or offer technical assistance.
- Managed time efficiently in order to complete all tasks within deadlines.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Strengthened communication skills through regular interactions with others.
- Organized and detail-oriented with a strong work ethic.
- Adaptable and proficient in learning new concepts quickly and efficiently.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Paid attention to detail while completing assignments.
Sends Coordinator
University of Colorado ClinImmune Labs, Aurora, CO
10.2015 - 09.2016
- Professional level management of electronic Histocompatibility Lab Manager files for solid organ and bone marrow recipients and donors
- Communicate with various levels of faculty, administrators, and staff regarding patient status and general operating procedures
- Review expenditures to assure compliance with budgets
- Respond to requests for information, research financial data, correct discrepancies, and ensure accurate financial reporting
- Reconcile month-end expense documentation
- Demonstrate initiative by assessing systems, making suggestions for streamlining, cost savings, and improving workflow
- Regularly review and update internal policies and procedures
- Professional level management of blood testing supplies for Bone Marrow National Registry transplant patients and solid organ candidates
- Management of patients in the United Network for Organ Sharing system
- Management, inventory, and general oversight of administrative and blood collection supplies
- Management and verification of physician orders in Epic for patients awaiting transplant
- Generate monthly requisitions for patients at dialysis units nationwide and work with clients to obtain test results.
- Coached employees through day-to-day work and complex problems.
- Entered data, generated reports, and produced tracking documents.
- Tracked records, filed documents and maintained communication between clients to manage office activities.
- Prepared agendas and took notes at meetings to archive proceedings.
- Participated in workshops and in-service meetings to enhance personal growth and professional development.
- Used job-related software to draft and finalize written correspondence and documentation.
Certified Nursing Assistant
05.2004 - 01.2016
- Participated in patient care assessments and assisted in development of patient treatment plans
- Provided direct patient care in accordance with treatment plans
- Demonstrated understanding of and utilized proper infection control policies and practices
- Accompanied patients as needed to various activities and functions
- Completed required charting/documentation accurately and in a timely manner
- Maintained a clean, safe and secure environment for patients
- Accessed continuing education opportunities as appropriate for the discipline in order to maintain clinical currency.
Cord Blood Consenter
University of Colorado ClinImmune Labs, Aurora, CO
11.2013 - 09.2015
- Professional level management of patient and familial data, and cord blood materials' inventory using spreadsheets, databases, dashboard reports and other analysis instruments for tracking and reporting
- Management of recruited and enrolled patient participants
- Conducted patient interviews to screen for donation eligibility
- Regularly reviewed and updated internal policies and procedures
- Completed risk assessment of the patient as well as gestational age of the baby
- Accessed Epic for patients' electronic medical records
- Demonstrated initiative by assessing systems, making suggestions for streamlining, cost savings, and improving workflow
- Assisted with annual budget proposals and other financial analyses as requested
- Reviewed expenditures to assure compliance with budgets
- Translated for all Spanish speaking patients and delivery nurses.
- Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
- Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
- Communicated with patients, ensuring that medical information was kept private.
- Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.
- Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
- Conducted routine facility inspections, identifying areas needing improvement and eliminating hazards posed to staff and residents for continued compliance with associated regulations.
- Designed and introduced leadership development, coaching and team management model, resulting in promotion of employees into increased levels of responsibility.
- Implemented successful healthcare program through professionalism, quality of care, medical teaching and patient satisfaction.
- Monitored and inspected staff processes to eliminate hazards posed for both residents and staff while ensuring continuous compliance with regulations.
- Discussed medical histories with patients in effort to provide most effective medical advice.
- Spearheaded and implemented new projects to expand scope of engagement.
Call Center Agent
City and County of Denver, Denver, CO
11.2010 - 12.2012
- Processed and resolved complex calls regarding Denver Human Services programs and services
- Provided information regarding compliance guidelines by having a working knowledge and understanding of various program procedures, guidelines, and requirements
- Navigated the Colorado Benefits Management System (CBMS) using multiple screens to determine necessary legal documents regarding eligibility
- Managed patient demographics database
- Provided thorough, complete and exemplary customer service at all times under all circumstances.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Adhered to company policies and scripts to consistently achieve call-time and quality standards.
- Responded to customer calls and emails to answer questions about products and services.
- Analyzed and escalated complaints, issues and grievances to designated departments for investigation and response.
- Maintained and encouraged customer loyalty through courteous and efficient resolution of disputes, complaints and discrepancies.
- Addressed customer account discrepancies and concerns.
- Verified accurate responses to questions and inquiries by maintaining advanced product knowledge.
- Received multiple positive reviews acknowledging dedication to excellent customer service.
Education
Bachelor of Science - Healthcare Management
Metropolitan State University of Denver
Denver, CO 05.2017
Skills
- Proficient using Microsoft Outlook, Word, Excel, PowerPoint and Access
- Proficient in English and Spanish
- Proficient in Colorado Benefits Management System
- Proficient in EPIC electronic medical record system
- Knowledge of HCM database and prior experience in PeopleSoft HR, PeopleSoft Finance, and COGNOS reporting
- Information Collection
- Medical Terminology
- Statistical Data Management
- Eligibility Determination
- Interpersonal Communication
- Staff Recruitment
- Team Leadership
- Critical Thinking
References
References available upon request.
Languages
Spanish
Native or Bilingual
Timeline
Patient Access Specialist
University Of Colorado Hospital
09.2023 - Current
Credentialing Specialist
Optum
04.2022 - Current
Grants Award Specialist
University of Colorado | Anschutz Medical Campus
11.2020 - 09.2021
Fiscal Tech (Accounting Technician II)
University of Colorado | Anschutz Medical Campus
02.2019 - 11.2020
Finance and Research Manager
University of Colorado Bioengineering Department
09.2016 - 02.2019
Sends Coordinator
University of Colorado ClinImmune Labs, Aurora, CO
10.2015 - 09.2016
Cord Blood Consenter
University of Colorado ClinImmune Labs, Aurora, CO
11.2013 - 09.2015
Call Center Agent
City and County of Denver, Denver, CO
11.2010 - 12.2012
Certified Nursing Assistant
05.2004 - 01.2016
Bachelor of Science - Healthcare Management
Metropolitan State University of Denver
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