Kristie Rodriguez-Garcia

Early and Periodic Screening, Diagnostic and Treatment lists of members are generated by health plan. Gathered relevant information for identified member population during assessment, care planning, interdisciplinary care team meeting, and transitions of care.

Made appropriate referrals for complex case management and social worker for crisis interventions and linked services.

Ensured insurance eligibility, benefit verification, and the authorization processes are complete prior to dates of services.

Verified insurance coverage immediately for inpatient and outpatient accounts that are same day and next day add-ons.

Determine if pre-certification, pre-authorization or a referral is required for insurance companies and obtain if applicable.

Communicate with providers and team regarding out-of-network issues, assess contracted and non-contracted payer issues, and document outcome.

• Communicated clearly and effectively with patients to verify information, determine purpose of visit and record medical history.
• Taught patients about medications, procedures, and care plan instructions.
• Supported duties for diagnostic and technical treatment procedures, such as setting up and operating special medical equipment and apparatus.
• Prepared and administered medications to alleviate patient symptoms..
• Assisted physicians with minor surgeries, including preparing operating room and sterilizing instruments.
• Assisted with routine checks and diagnostic testing by collecting and processing specimens..
• Performed medical records management, including filing, organizing and scanning documents
• Liaised with patients and addressed inquiries, appointment requests and billing questions
• Called and faxed pharmacies to submit prescriptions and refills