Leyda Concepcion
Kissimmee,FL
Overview
9
9
years of professional experience
Work History
Referral Coordinator
IMA Medical Group
06.2024 - Current
- Managed patient referral process from initial consultation to specialist appointment, ensuring timely access to necessary medical services
- Resolved conflicts between referring physicians and receiving providers
- Assessed need for additional staff, equipment and services based on historical data and seasonal trends
- Participated in training and professional development opportunities to stay current with best practices in referral coordination
- Assisted in the development of referral processes and procedures
- Maintained confidentiality of patient information in compliance with HIPAA regulations
- Monitored referral outcomes, reporting on trends and areas for improvement to healthcare management teams
- Established solid relations with leadership and staff by attending board meetings and coordinating interdepartmental information exchanges
Bilingual Customer Service Specialist
Optum, UnitedHealth Group
02.2023 - 09.2023
- Calling members to scheduled their annual Wellness check with the NP at their home
- Updating members information
- Inbound and outbound calls from60 to100 per day
- Insurance verification
Assembler/Production Worker
Abbott Laboratories Limited
12.2020 - 09.2022
- Identified and resolved assembly and production issues or malfunctions
- Assemble components according to specifications using hand tools, power tools, and other equipment
- Adhered to work safety standards, wore protective equipment and removed workplace hazards from job sites
- Set up and performed hand and automatic assembly operations on components, sub-assemblies and assemblies
- Provide feedback on design changes that could improve efficiency of the production line
- Operated and maintained equipment in a clean and safe condition
- Performed visual and mechanical quality verifications to meet customer specifications
Bilingual Call Center Representative
Premier Medical Associates
10.2019 - 12.2020
- Resolved issues dealing with patient's healthcare claims
- Answer telephones and direct calls to appropriate staff
- Schedule and confirm patient diagnostic appointments, surgeries, or medical consultations
- Collect initial premiums and issue receipts
- Review insurance policy to determine coverage
- Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedures, or treatment into computer
- Protect the security of medical records to ensure that confidentiality is maintained
- Call pharmacy for refill of prescription medication
Prior Authorization Specialist
Advantage Media Group
02.2018 - 09.2019
- Assign the patient to diagnosis-related groups (DRGs), using appropriate computer software
- Compile and maintain patients' medical records to document condition and treatment and to provide data for research or cost control and care improvement efforts
- Consult classification manuals to locate information about disease processes
- Identify, compile, abstract, and code patient data, using standard classification systems
- Protect the security of medical records to ensure that confidentiality is maintained
- Resolve or clarify codes or diagnoses with conflicting, missing, or unclear information by consulting with doctors or others or by participating in the coding team's regular meetings
- Prepare insurance claim forms or related documents, and review them for completeness
Bilingual Medical Clinical Receptionist
Neurology Consultants
05.2016 - 02.2018
- €¢ Answer telephones and direct calls to appropriate staff
- €¢ Schedule and confirm patient diagnostic appointments, surgeries, or medical consultations
- €¢ Complete insurance or other claim forms
- €¢ Greet visitors, ascertain purpose of visit, and direct them to appropriate staff
- €¢ Transmit correspondence or medical records by mail, e-mail, or fax
- €¢ Maintain medical records
- €¢ Compile data or documentation
- €¢ Scan patients' health records into electronic formats
- €¢ Review records for completeness, accuracy, and compliance with regulations
- €¢ Retrieve patient medical records for physicians, technicians, or other medical personnel
- €¢ Release information to persons or agencies according to regulations
- €¢ Protect the security of medical records to ensure that confidentiality is maintained
- €¢ Process and prepare business or government forms
- €¢ Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedures, or treatment into computer
- €¢ Compile and maintain patients' medical records to document condition and treatment and to provide data for research or cost control and care improvement efforts
- €¢ Collect initial premiums and issue receipts
Bilingual Medical Clinical Receptionist
Neurology Consultants
05.2016 - 02.2018
- Answer telephones and direct calls to appropriate staff
- Schedule and confirm patient diagnostic appointments, surgeries, or medical consultations
- Complete insurance or other claim forms
- Greet visitors, ascertain purpose of visit, and direct them to appropriate staff
- Transmit correspondence or medical records by mail, e-mail, or fax
- Maintain medical records
- Compile data or documentation
- Scan patients' health records into electronic formats
- Review records for completeness, accuracy, and compliance with regulations
- Retrieve patient medical records for physicians, technicians, or other medical personnel
- Release information to persons or agencies according to regulations
- Protect the security of medical records to ensure that confidentiality is maintained
- Process and prepare business or government forms
- Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedures, or treatment into computer
- Compile and maintain patients' medical records to document condition and treatment and to provide data for research or cost control and care improvement efforts
- Collect initial premiums and issue receipts
Education
Bachelor - Allied Health Management
Florida Technical College
Orlando, FLHigh School Diploma - undefined
Wells Academy High School
Chicago, IL05.1986
Skills
- Insurance precertification processes
- Multi-line phone proficiency
- Multi-line telephone operation
- Notetaking and documentation
- Patient records oversight
- Pre-authorizations
- Referral wait list management
- HIPAA regulations
- Appointment reminders
- Lead generation
- Organizational growth
- Healthcare systems
- Scheduling software
- Prospecting
- Data entry proficiency
- MS office expertise
- Accurate documentation
- Database management
- Referral tracking
- Physician authorizations
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Referral Coordinator
IMA Medical Group
06.2024 - Current
Bilingual Customer Service Specialist
Optum, UnitedHealth Group
02.2023 - 09.2023
Assembler/Production Worker
Abbott Laboratories Limited
12.2020 - 09.2022
Bilingual Call Center Representative
Premier Medical Associates
10.2019 - 12.2020
Prior Authorization Specialist
Advantage Media Group
02.2018 - 09.2019
Bilingual Medical Clinical Receptionist
Neurology Consultants
05.2016 - 02.2018
Bilingual Medical Clinical Receptionist
Neurology Consultants
05.2016 - 02.2018
Bachelor - Allied Health Management
Florida Technical College
High School Diploma - undefined
Wells Academy High School
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