Alicia Arriola
Placitas
Summary
A Flexible professional who enjoys learning new skills and quickly adapts to organizational changes. Highly motivated goal-oriented and professional: a decision-maker skilled in implementing new ideas. Innovative, enthusiastic, and uncompromising work ethic.
Overview
13
13
years of professional experience
Work History
Senior Assessment Management Systems
Sandoval County
10.2023 - Current
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Managed time efficiently in order to complete all tasks within deadlines.
- Completed data entry tasks with accuracy and efficiency.
- Verified accuracy of data entered into system to produce error-free reports.
- Sorted documents and maintained organized filing process.
- Verified entered data against source documents to maintain consistency across multiple platforms within the organization.
- Communicated with supervisors and colleagues to process data quickly and resolve discrepancies.
- Performed regular audits on database content to identify outdated or inaccurate records requiring updates or removals.
- Maintained confidentiality and security of all information, ensuring compliance with data protection regulations.
- Supported successful audit processes by providing accurate and timely data reports.
- Checked for accuracy by verifying data and records.
- Enhanced assessment processes by implementing efficient data management and analysis techniques.
Patient Support Lead
Presbyterian Medical Group
10.2018 - 09.2023
- Researched questions and concerns from providers and provided detailed responses
- VFC coordinator (Order pediatric and Covid vaccines, monthly Medical Supply, Tricore, Laundry, Office Depot, Forms and business cards, bio card, Dietary Orders
- No Show and Termination Process, Immediate Terminations
- Template Management/Building, Provider Schedules Blocks, Reschedules and Meeting Blocks
- Manage Daily Deposit for Family Practice, Paradise FP Void Pool, and change request
- PCSC Escalation Distribution
- SME for Clerical Practices
- Registration Coverage, Check Out Coverage, PA Back Up, RQA Monitoring, PPE Inventory back up
- Update phone list, clerical job aid
- Submission of SR request
- Clerical Staff Schedules and staffer link request
- Participated and led employee staff meetings, reporting trends in procedures, advising leadership on resources needed and receiving information to be disseminated
- Implemented care and efficiency improvements to support and enhance office operations
- Monitored office procedures to correct problems and implement proactive improvements for better patient flow
- Assisted in the maintenance of medical charts and/or electronic medical record (filing, Op Reports, test results, home care forms)
- Enhanced patient outcomes by providing knowledgeable education on procedures, medications and other physician instructions
- Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment
- Developed team communications and information for employee meetings
- Daily review of work queues; Patient, Referral, STAT& ASAP
- Complete pre-registration prior to patients’ appointments
- Devoted special emphasis to punctuality and worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately
- Determined prior authorizations for outpatient services
- Verified important patient information data including insurance, demographic for entry into the patient management system
- Coordinated with nursing staff to process and direct patients to the appropriate departments
- Facilitated timely check-in by greeting visitors and establishing the purpose of their visit and maintain cleanliness of reception area to maintain welcoming environment
- Collected and processed co-payments and out-of-pocket charges using Epic
- Call insurance companies to get precertification and other benefits information on behalf of patients
- Reviewed incoming correspondence and determined the action required and its priority
- Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout the process and assisted with scheduling appointments
- Scheduled, rescheduled and handled cancelled appointments for patients
Prior Authorization Specialist
Armada Skilled Homecare
10.2017 - 09.2018
- Determined prior authorizations for outpatient services
- Prepared patient charts, pre-admissions and consent forms as necessary
- Examined patients’ insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable
- Researched questions and concerns from providers and provided detailed responses
- Assisted in the maintenance of medical charts and/or electronic medical record (filing, Op Reports, test results, home care forms)
- Responded to correspondence from insurance companies
- Answered incoming phone calls and addressed questions from customers and healthcare providers
- EFax Authorization Request to insurance companies for home health services
- Run daily reports
Lead supply coordinator
HME Specialists llc
04.2012 - 04.2016
- Helped employees with day-to-day work and complex problems by applying motivational and analytical strategies
- Enhanced collaboration between team members by preparing meeting materials and taking clear notes to distribute to stakeholders
- Responsible for training all new employees
- Process orders for CPAP, incontinence, enteral, catheters, and wound supplies
- Verify patient’s insurance coverage for Durable Medical Equipment via email, phone, insurance portals and MVP, Verify timely filing, CMN status, patient’s co-pays, coinsurance and deductibles
- Request authorizations, clinical, prescriptions, sleep studies and any medical chart notes to qualify patients
- Assist management with customer complaints, open orders reports, back order reports, and VGM fulfillment reports, knowledge and experienced with Brightree, ShoreTel, HIPAA and Medicare guidelines, ICD9 and HCPCs
Education
High school diploma -
Bernalillo High School
01.2003
Skills
- Professional phone etiquette
- Excellent communication skills
- Database management
- Team Building
- Invoice Processing
- Advanced clerical knowledge
- Multi-line phone proficiency
- Strong client relations
- Conference planning
- Employee training and development
- Flexible
- Excellent planner and coordinator
- Works well under pressure
- Detail-oriented
- Quick learner
- Dependable and responsible
- Multitasking Abilities
- Critical thinking
- Computer skills
- Organizational skills
Timeline
Senior Assessment Management Systems
Sandoval County
10.2023 - Current
Patient Support Lead
Presbyterian Medical Group
10.2018 - 09.2023
Prior Authorization Specialist
Armada Skilled Homecare
10.2017 - 09.2018
Lead supply coordinator
HME Specialists llc
04.2012 - 04.2016
High school diploma -
Bernalillo High School
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