Karla Cardenas

Pre-Litigation Paralegals provide support for legal team and clients to ensure Law Group provides excellent client service. Case Manager is responsible for handling pre-litigation matters primarily from the treating phase through demand stages.

• Submit mailing documents for translation
• Data entry of case into database
• Correspondence with client, providers, and insurance companies.
• Maintain workflow by assuring prompt and accurate handling of assigning cases.
• Provide general support to handling Paralegal.
• Provide a positive attitude, highly organized with excellent attention to detail.
• Confirm accuracy of weekly report prior to case manager submitting to counsel.
• Ability to independently make decisions of processing referrals and insurance based on clinical readiness.
• Prepare declarations for final approval and accounting.

• Collaborated with Management team to ensure compliance requirements are met.
• Effectively managed large caseloads of multiple priority levels within a changing environment.
• Developed standardized policies and procedures
• Monitor processing of cases for patients with specialty pharmacy vendors and to overcome delays in turnaround times and other obstacles.
• Motivated and trained employees to maximize team productivity.
• Trained new employees on proper protocols and customer service standards.

• Reviewed documentation for accuracy and assessment of necessity.
• Maintained consistent follow-up on the status of prior authorization and referral requests.
• Performed duties of Assistant Coordinator, and specialist in accordance with applicable standards, policies, and regulatory guidelines.
• Oversaw the daily activities of the referral coordinators, providing direct supervision and guidance.

• Collected, organized, and entered patient data into medical systems.
• Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
• Contacted insurance companies to discuss and resolve unpaid claims and incorrectly paid claims.
• Scanned, received, and sent faxes to insurance claims, co-pay assistance information, and patient documentation.

• Developed deep knowledge of customer businesses and relationships to company objectives.
• Exceeded sales goals for business accounts by bringing in 100+ new accounts and upselling Banking products to existing clients.
• Cultivated productive relationships with business representatives and consulted closely to uncover needs and match available solutions.
• Contributed to annual revenue goals by selling new services and developing new accounts.
• Continuouslyself-developments by using resources and technologies to optimize the client experience.

• Audited files for completion and accuracy.
• Welcoming and facilitating new admits into the skilled nursing setting and follow up as necessary.
• Participate in touring and orientation of potential residents/family members.
• Assist in arranging transportation to other facilities when necessary.
• Ensured that an initial resident assessment is completed within fourteen (14) days of the Resident's admission.
• Ensured that a comprehensive care plan is completed within twenty-one (21) days of the Resident's admission.
• Maintains open communication with liaisons and internal staff regarding bed availability and staffing.
• Effectively managed the care of assigned patients using knowledge, skills, judgment, and decision-making skills for the specific area.
• Engaged residents through events, small groups, and personal attention.
• Helped residents build and maintain interpersonal relationships, social skills, mental abilities, and confidence.