Julie Garcia

Developing and coordinating health care programs Communicating between staff, patients and family Handling patient case management and education Developing patient goals and monitoring progress Maintaining patient confidentiality and quality care.

Prepared patients charts, Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors, Executed record filing system to improve document organization and management. Notifying physicians offices of patients history and physical. Created and maintained databases to track and record customer data.

Assisted with routine checks and diagnostic testing by collecting and processing specimens. Directed patients to exam rooms, fielded questions and prepared for physician examinations. Documented vital signs and health history for patients in clinic and hospital environments. Promoted office efficiency, coordinating charts, completing insurance forms and helping patients with diverse needs. Obtained all prescribed laboratory testing. Arranged surgeries with surgical center, confirming times with patients and preparing admission and consent forms. Called and faxed pharmacies to submit prescriptions and refills. Completed clinical procedures and gathered patient data for interpretation by physician. Taught patients about medications, procedures, and care plan instructions. Answered telephone calls to offer office information, answer questions, and direct calls to staff. Completed EKGs and other tests based on patient presentation in office

Supported all functions of the call center, responded to escalated inquiries from members, providers, and delegated entities. Provided superior product and benefit information. Processed member transactions, including but not limited to PCP changes, demographic change and membership material request. Collaborated with customer service, Enrollment, Claims, Health Services, Pharmacy, A&G and Sales to ensure that members and provider request are appropriately resolved Met individual and department standards. Identified issues impacting customer services' ability to adequately provide information or assistance to members

Greeted and scheduled patients and visitors. Responsible for reminder calls of appointments. Responsible for billing, answered and routed calls, making transactions, and keeping paperwork organized. Notified patients of any deductible and/or coinsurance due, contact customer directly when necessary to obtain additional information. Contact Primary Care Physicians with regard to referral information, Complies.Pre-certification information and forwards to insurance company to establish medical necessity and prior approval. Researched other payment options with customer, when appropriate. Performed regular follow- up calls with insurance companies checking status of prior authorization request, Submits additional documentation, if required. Triaged patients; entered patient's information in system. Checked patient insurance, demographic and health history to keep information current.