Laura P. Martinez
Cathedral City,CA
Summary
Conscientious and organized individual with exceptional time management ability. Exceptional work ethics and ensure optimum customer service and care. Personable team player with superior communication and interpersonal skills. Proactive and committed to improving processes, achieving goals and employee development.
Overview
16
16
years of professional experience
Work History
Real Estate Agent
HomeSmart Professionals
Palm Desert, CA
01.2024 - Current
- Offer comprehensive real estate services encompassing property sales, marketing, and client consultations.
- Direct clients through every step of the transaction process.
- Conduct market analysis to determine competitive pricing and trends.
Clinical Administrative Coordinator
UnitedHealthcare/Optum
Palm Desert, CA
09.2016 - 02.2022
- Ensures accurate and thorough documentation and completion of all necessary requests for referrals/prior authorization processes of various health plans.
- Access medical electronic member files using policy or id number.
- Verification of member health insurance with various health plans.
- Work closely with referring physicians, medical staff, case managers, durable medical equipment team, hospital clinical team and Medical Directors.
- Develop and maintain current knowledge of profile/queue workflow.
- Member triage, gather necessary information, and assess urgency.
- Administrative intake of members or managing the admission/discharge information post-notification and census roles.
- Managing incoming calls/requests for services from members, hospital clinical team, physicians, medical staff, case managers and durable medical equipment team.
- Providing information on available network services and transferring as appropriate to clinical staff.
- Work Effectively and maintain expected productivity.
- Explanation of benefits and authorization information to members/providers.
- Communicate with the clinical team to ensure the provider receives a response when necessary.
- Enter data into the relevant computer system for creation of authorization.
UM Technician
Empire Physicians Medical Group
Palm Desert, CA
09.2016 - 09.2016
- Responsible for management of project timelines related to assigned enrollment requests, adhering to standard turnaround times and meeting all customer enrollment event deadlines.
- Initiates the verification and pre-authorization process.
- Attends staff meetings, in- services, insurance payer meetings or web- based training.
- Utilizes updated Insurance Matrix information.
- Verification of member health insurance.
- Explanation of benefits and authorization information to members/providers.
- Work Effectively and maintain expected productivity.
- Communicate with insurance carriers regarding clinical information requested to resolve issues relating to specific patient benefits.
Referrals Coordinator
Dr. Homan Abdollahzadeh, M.D.
Palm Springs, CA
08.2015 - 09.2016
- Responsible for submitting requests to health plans for prior authorization.
- Scheduling members for hospital procedures inpatient & outpatient center.
- Communicating with members for procedure preparation and instructions.
- Collection of co-payments.
- Chart preparation and scheduling 50 - 60 patients per day.
- Verification of members benefits.
- Answered phone calls and made outbound calls to patients, facilities and doctor offices.
Medical Assistant/ Back Office
Dr. Mario Ramos M.D.
Palm Springs, CA
09.2010 - 01.2011
- Prepped patients and rooms for various types of medical exams, took vital signs, collected lab specimens, filed documents, answered phones, organized medical supply rooms, performed injections, wound care, communicated with pharmacies to submit prescriptions, scheduled appointments, and submission of referrals.
Medical Assistant/ Back Office
Dr. Nina K Maw Maw M.D.
Rancho Mirage, CA
08.2008 - 08.2010
- Prepped patients and rooms for various types of medical exams, took vital signs, collected lab specimens, filed documents, answered phones, organized medical supply rooms, performed injections, wound care, communicated with pharmacies to submit prescriptions, scheduled appointments, and submission of referrals.
Skills
- Knowledge of HIPPA Privacy Laws
- Referrals/Prior Authorization Review & Processing
- Knowledge of ICD-10, CPT & HCPCS
- Workflow Management
- Policy and Decision Implementation
- Medical Terminology
- Member Triage
- Health Insurance Verification Via Provider Portal & Telecommunications
- Knowledge of Health Insurance Matrix
- Data Entry
- Customer Service
- Microsoft Office
- Data Management
- Planning & Organizing
- Licensed Real Estate Agent, California DRE License # 02229950
- Active Member, California Desert Association of REALTORS
Languages
- Bilingual - English & Spanish
EMPLOYMENT HISTORY
8/2015 - 9/2016 Dr. Homan Abdollahzadeh, M.D. Gastroenterology, Palm Springs, CA
1/06/14 - 06/25/15 Carquest of the Desert, Cathedral City, CA
9/2010 - 1/2011 Dr. Mario Ramos M.D. ( Family Practice) Palm Springs, CA
8/18/11 - 10/01/11 Los Angeles Times, Cathedral City, CA
8/2008 - 8/2010 DR. Nina K Maw Maw M.D. ( Family Practice) Rancho Mirage, CA
12/26/07 - 7/27/08 Agua Caliente Casino, Rancho Mirage, CA
3/2006 - 4/2006 Santo Tomas Dental, Cathedral City, CA
6/2003 - 12/2003 Desert Regional Medical Center, Palm Springs, CA
10/2002 - 4/ 2003 Addus Health Care, Cathedral City, CA
PROFESSIONAL REFERENCES
Marlene Moreno - 1184 Mountain Hawk Lane, Desert Hot Springs, CA 92240
(760) 902-1980
Luis Angel Rodriguez - 555 Tachevah Suite # 1W302, Palm Springs, CA 92262
(760) 323-9818
Maria Resendiz - 1330 N Indian Canyon Dr STE F, Palm Springs, CA 92262
(760) 218-7341
Timeline
Real Estate Agent
HomeSmart Professionals
01.2024 - Current
Clinical Administrative Coordinator
UnitedHealthcare/Optum
09.2016 - 02.2022
UM Technician
Empire Physicians Medical Group
09.2016 - 09.2016
Referrals Coordinator
Dr. Homan Abdollahzadeh, M.D.
08.2015 - 09.2016
Medical Assistant/ Back Office
Dr. Mario Ramos M.D.
09.2010 - 01.2011
Medical Assistant/ Back Office
Dr. Nina K Maw Maw M.D.
08.2008 - 08.2010
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