Lizbeth Falcon
Lutz,Florida
Summary
Highly motivated and committed individual with proven history of superior performance at individual, team and organizational levels. Multitasks and prioritizes workloads with little or no supervision. Detail-oriented professional looking to bring career background and team-building skills to deadline-driven environment. Conscientious professional offering over 20+ years of experience in fast-paced settings. Positive and upbeat with excellent communication skills. Motivated to learn, grow and excel. Hardworking and passionate job seeker with strong organizational skills. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Excellent reputation for resolving problems and improving customer satisfaction. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
17
17
years of professional experience
Work History
Medical & Legal Bilingual Interpreter/Translator
FREELANCE SPANISH INTERPRETER
Tampa, FL
01.2015 - Current
- Precisely and accurately interpret critical medical advice and information given by the provider into equivalent terminology in the patient's native language
- Assist in translating medical text from English to Spanish on behalf of internal and external customers; translate patient education information as specifically requested
- Establish and maintain quality service and positive interaction with all patients, customers, visitors, health care providers, and clinical employees
- Assist with patient follow-up as necessary and report to specific company
- Maintained zero language-barrier rate, thanks to native-speaker-level grasp of
- Spanish language and deep cultural competency
- Legal interpreting On-Site, Video Remote (VRI) and Telephonically (OPI)
- Provide legal interpretation and translation services at Depositions, Arbitrations,
- Mediations, Litigation Matters, Settlement conferences, Client meetings
- Conducted interpretations and provided translations of affidavits and other legal documents
- Rendering sight interpretation of legal documents.
Care Coordinator/Referral Specialist, Appeals Coordinator
WellCare Health plans
Tampa, FL
01.2014 - 03.2021
- Assist, complete and submits special projects, reports or assignments to meet
- Utilization Management department needs and objectives
- Serve as liaison in corresponding and communicating with providers, vendors and
- WellCare contacts and/or members representatives
- Produce, format and edit correspondence and documents
- Interact and Cross train with other departments including HHS and DME, Intake,
- Provider Relations and Member Services to resolve member and provider issues
- Provide written and verbal education and training to new staff
- Coordinates and handles all member and provider appeals and grievances, including member grievances, appeals, requests and disputes
- Receipt and processing of all incoming mail for Appeals Department
- Maintain knowledge of all system, contractual, compliance standard changes and policy updates, and attend additional training sessions as necessary
- Supports tasks, including but not limited to: faxes, discharge preparations, request and/or collection of clinical information, engaging/contacting providers and creation of authorizations if necessary
- Performs other duties as assigned.
Medical Claims Auditor
Traveler’s Insurance
Tampa, FL
01.2012 - 01.2014
- Worker’s Compensation Claims
- Review over 100 worker’s compensation claims daily
- Investigate medical claim data and/ or medical records to identify payment errors
- Investigate medical claims on client claim systems, conducting medical incident & coding reviews
- Responsible for making necessary corrections to CPT codes, DX codes, Charge amounts, Date of services, NDC codes
- Communication with adjusters and management on review findings, assist with error validation process
- Responsible for researching claim processing problems and errors to determine their origin and appropriate resolution
- Analyze data processing reports and make necessary corrections and adjustments
Education
Associates Degree - Accounting and Finance
FMU (Florida Metropolitan University)
2005
Skills
- Proficient with office package: Microsoft Word, Microsoft Excel, Microsoft Access, Microsoft PowerPoint and Microsoft Outlook Express
- Skilled in Spanish legal and medical terminology
- Proficiency in database manipulation
- Strong analytical, investigative and decision-making skills
- Proficient with healthcare claim adjudication standards and procedures
- Efficient and accurate Spanish medical and legal interpreter with 7 years of experience
- Certified California Medical Bill Reviewer
- Flexible attitude, detail oriented and excellent at meeting deadlines
- Outstanding communication skills with ability to relate to customers, providers, employees and staff members
- Fast Learner, capable to learn new system, software and hardware technology quickly
Timeline
Medical & Legal Bilingual Interpreter/Translator
FREELANCE SPANISH INTERPRETER
01.2015 - Current
Care Coordinator/Referral Specialist, Appeals Coordinator
WellCare Health plans
01.2014 - 03.2021
Medical Claims Auditor
Traveler’s Insurance
01.2012 - 01.2014
Associates Degree - Accounting and Finance
FMU (Florida Metropolitan University)
Similar Profiles
Jean Charles DensyJean Charles Densy
Global Interpreter ,effectiff at Inglish,haitian Creol,Spanish, Interpreter,Global Interpreter ,effectiff at Inglish,haitian Creol,Spanish, Interpreter,
Veronica NovoaVeronica Novoa
Lexington Regional Health Center at Spanish InterpreterLexington Regional Health Center at Spanish Interpreter
Nardine DesulmaNardine Desulma
NA at Freelance Translator and interpreterNA at Freelance Translator and interpreter