Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments.
Overview
12
12
years of professional experience
Work History
Family Caregiver
Private Household
03.2025 - Current
• Rapidly developed strong working knowledge of cardiology, including heart failure management and transplant evaluation, through direct, hands-on involvement in care coordination
• Gained in-depth familiarity with guideline-directed medical therapy (GDMT) for advanced heart failure, including medication classes, titration goals, and treatment pathways
• Coordinated complex cardiology care for a heart transplant candidate, including scheduling evaluations, managing referrals, and tracking follow-ups across multiple providers
• Communicated effectively with multidisciplinary teams, including cardiologists, transplant coordinators, surgeons, and insurance representatives
• Facilitated timely exchange of medical information and ensured completion of required documentation for transplant eligibility and referrals
• Advocated for patient needs by navigating healthcare systems, resolving scheduling and authorization issues, and ensuring continuity of care
• Maintained detailed records, monitored critical timelines, and prioritized tasks in a high-pressure, time-sensitive environment
Sr. Claims Technician
Health Care Service Corporation
02.2020 - 05.2024
Reviewed documentation for accuracy, minimizing errors in the authorization workflow.
Coordinated patient referrals to ensure timely access to specialized care.
Communicated with healthcare providers to clarify referral processes and requirements.
Maintained accurate patient records in electronic health systems for seamless information sharing.
Evaluated patient authorization requests for accuracy and compliance with insurance guidelines.
Calculated estimated copay based on current insurance benefits.
Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Calculated adjustments, premiums and refunds.
Customer Service Representative
SeneGence International
02.2017 - 02.2020
Trained new Customer Service Representatives from Mexico and Hong Kong on the internal operating systems, customer service protocols and best practices, fostering a collaborative environment.
Processed orders and returns, ensuring timely fulfillment and customer satisfaction.
Maintained detailed records of customer interactions in CRM systems for effective follow-up.
Collaborated with team members to improve service processes and enhance customer experience.