Liset Leal

Served as a trusted resource for clinical staff seeking guidance on appropriate levels of care, alternate treatment options, or clarification on insurance coverage requirements.

• Evaluated medical necessity criteria using evidence-based guidelines to ensure that services provided were both clinically appropriate and cost effective.
• Provided ongoing education to clinical staff on the importance of proper documentation for optimal reimbursement and compliance with regulations.
• Managed complex cases involving multiple medical conditions, coordinating care among various specialists while adhering to strict timelines for decision making.
• Obtained authorizations from multiple insurance carriers for various levels of care.
• Maintained confidentiality and security of patient data, adhering to all relevant privacy laws and regulations.
• Devise or identify solutions for irregular requests and issues.
• Supported positive working relationships between physicians, nursing staff, and other healthcare professionals through clear communication and collaboration on patient-centered goals.

• Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
• Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
• Assisted customers with Spanish-language inquiries in a timely and professional manner.
• Enhanced customer satisfaction by addressing and resolving complex inquiries in both English and Spanish languages.
• Met all call quality standards and daily quotas for first-call resolution.
• Collaborated with other departments as needed to resolve customer issues that required cross-functional support or expertise.
• Managed approximately 100 incoming calls on daily basis

• Answer and screen incoming calls from patients, addressing inquiries and concerns promptly and professionally
• Schedule various medical tests and procedures efficiently, ensuring optimal use of resources and patient convenience
• Manage prescription refills process, coordinating with healthcare providers and pharmacies to facilitate timely medication renewal
• Arrange patient appointments, accommodating their preferences and maintaining an organized schedule
• Provide clear instructions to patients regarding medical tests, ensuring proper preparation and understanding of procedures
• Exceed monthly call goals by effectively managing call volume and maintaining high-quality interactions
• Verify patient insurance coverage accurately and inform patients of their financial responsibilities
• Communicate empathetically with clinic patients, addressing their needs and concerns with compassion and efficiency
• Coordinate pre- and post-operative schedules, ensuring patients are prepared for procedures and receive necessary follow-up care
• Achievements:
• Consistently exceeded monthly call goals by managing call volume, demonstrating exceptional communication and time management skills
• Established efficient scheduling processes for medical tests and appointments, enhancing patient satisfaction and optimizing clinic resources
• Successfully navigated insurance verification procedures, reducing billing errors and ensuring seamless payment processing
• Scheduled and confirmed appointments
• Answered and directed incoming calls using a multi-line telephone system
• Delivered administrative support to team members by making copies, sending faxes, organizing documents and rearranging schedules
• Sorted incoming mail and directed to correct personnel each day
• Entered data in Traverse software to keep records of plastic inventory
• Screened and verified visitors for identification credentials and purpose of visit to maintain security of personnel and office environment
• Assisted three visitors per afternoon by directing appropriate personnel
• Checked announcements and new policy documents for proper formatting, grammar, Spanish translation and spelling using Microsoft Word
• Answered phone calls, provided information to callers and connected callers to appropriate people

• Photocopied correspondence, documents and other printed materials
• Assisted in maintaining department attorney personnel files with utmost confidentiality
• Acted as liaison between clients, vendors and attorneys
• Processed and distributed invoices to bill clients
• Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services
• Juggled multiple projects and tasks to ensure high quality and timely delivery
• Demonstrated self-reliance by meeting and exceeding workflow needs
• Provided excellent service and attention to customers when face-to-face or through phone conversations

• Delegated daily tasks to team members to optimize group productivity
• Mentored staff to enhance skills and achieve daily targets, using hands-on leadership
• Directed and led employees, supervising activities to drive productivity and efficiency
• Collaborated with the store manager to develop strategies for achieving sales and profit goals
• Organized schedules, workflows and shift coverage to meet expected business demands
• Initiated inventory control measures to manage and replenish stock, maintain cost levels and meet customer demand
• Implemented training processes for newly hired employees and supervised department managers, shift leads and production personnel