LYNETT MELENDEZ
Kissimmee
Summary
Results-driven professional with over 20 years of experience across customer service, healthcare, and business operations. Proven track record of delivering exceptional client and patient support, improving operational efficiency, and managing high-volume workflows in fast-paced environments. Skilled in leadership, relationship management, problem-solving, and cross-functional collaboration, with expertise in healthcare coordination, administrative operations, client relations, and business development. Adept at building strong customer relationships, streamlining processes, and driving organizational success while maintaining the highest standards of professionalism, compliance, and service excellence.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Operations Manager
Mad Financials LLC
Kissimmee
06.2007 - Current
- Assist clients with life insurance, tax returns, immigration forms, and credit-building services.
- Provide business creation and credit-building management to clients.
Patient Care Manager/ Care Coordinator/ Medical Assistant / HEDIS Specialist
Osceola Community Health Services
Kissimmee
03.2021 - 03.2025
- Collaborated with healthcare providers to coordinate patient treatments and ensure services met medical necessity.
- Educated patients on procedures, healthcare instructions, and referrals.
- Connected patients to social services such as transportation assistance and translation services.
- Performed regular follow-ups with patients to monitor progress and promote continuity of care.
- Managed and update patient records in accordance with healthcare protocols.
- Worked with other healthcare providers and specialists to schedule appointments and develop treatment plans.
- Monitored patient progress and document outcomes.
- Provided support for securing funding for medical care.
- Reviewed medical records to extract clinical data for HEDIS reporting, including lab test results, hypertension and blood pressure readings, prenatal care, and more.
- Updated patient HEDIS forms to meet calendar year requirements and track healthcare quality metrics.
- Managed Humana and CarePlus patient load for insurance gaps and chart audits.
- Responsible for coordinating patient check-ins and verifying eligibility for services.
- Managed billing and patient records, adhering to HIPAA and OCHS policies.
- Scheduled appointments and assist with office equipment and insurance portals.
HEDIS Abstractor
eTeam Inc, Optum Health United Healthcare
Remote
10.2023 - 02.2024
- Conducted thorough medical record reviews for HEDIS measures, ensuring accurate data extraction.
- Collaborated with clinical teams to resolve data discrepancies and ensure timely reporting.
Patient Care Coordinator / CCM Care Manager
TimeDoc Health
Chicago
06.2019 - 01.2021
- Enrolled chronically ill patients in Medicare programs and completed monthly care calls.
- Monitored patient progress and facilitated necessary services such as medication refills and appointments.
Youth Care Worker
AB Staffing Solutions
Homestead
11.2018 - 05.2019
- Provided direct care and supervision for adolescents, ensuring compliance with policies and quality care standards.
Patient Services Representative
Medassist, A Firstsource Company
Miami
03.2018 - 06.2018
- Supervised and managed daily activities of Eligibility staff, both in-office and on-site at client locations.
- Provided detailed daily and weekly account reports to the Department Manager.
- Led staff training initiatives to ensure team members were well-prepared and aligned with company standards.
- Monitored and maintained time and attendance records for staff, ensuring accurate and timely submissions.
- Delegated tasks, inspected workflows, and coordinated responsibilities to ensure operational efficiency during high workload periods or absenteeism.
- Consistently met or exceeded departmental goals and objectives set by management.
- Documented and reported employee disciplinary issues to the department manager for appropriate action.
- Maintained strong working relationships with both state and federal agencies to ensure smooth operations.
- Provided guidance and assistance to other patient representatives in navigating account-related queries and tasks.
- Directed the overall workflow of the unit to ensure efficiency and accuracy.
- Handled escalated calls and addressed issues promptly to ensure customer satisfaction.
- Actively participated in the Corporate Compliance Program to ensure adherence to legal and regulatory standards.
Patient Scheduling Coordinator
American Health Connections
Beverly Hills
01.2017 - 06.2017
- Coordinated centralized scheduling and patient pre-registration.
- Verified insurance, collected deductibles/copays, and scheduled language.
- Managed appointment reminders, discharge follow-up, and physician referrals.
Front Desk/Medical Assistant
Heartwell Diagnostics
09.2014 - 07.2016
- Managed patient check-ins, appointment scheduling, and answered phone inquiries.
- Maintained organized office and waiting areas, adhering to safety and security protocols.
- Ensured confidentiality and customer service in compliance with HIPAA.
Front Desk/Medication Assistant
The Kidney Treatment Center
04.2014 - 08.2014
- Interviewed patients, measured vital signs, and assisted in medication preparation.
- Collected specimens, explained procedures, and ensured patient comfort.
Medical Assistant (Externship)
ABC Pediatrics
04.2013 - 02.2014
- Scheduled appointments, prepared patients for exams, and recorded medical history.
- Assisted in routine lab tests, injections, and explained medical procedures to patients.
Education
Bachelor's - Psychology
Keiser University
Associates - General Studies (Psychology Concentration)
Keiser University
Lakeland, FLDiploma - Medical Assistant Technician
Florida Career College
Miami, FLSkills
- Patient Care Coordination
- HEDIS Abstraction
- Medical Records Review
- Healthcare Administration
- Medical Assisting
- Care Management
- Insurance Verification
- HIPAA Compliance
- Appointment Scheduling
- Patient Education
- Chronic Care Management
- Billing and Documentation
- Provider Collaboration
- Quality Assurance
- Customer Service
- Team Leadership
- Life Insurance Consulting
- Business Operations Management
- Data Entry and Reporting
- Problem Solving
Certification
- Licensed Life Insurance Agent, Florida
- Public Notary, Florida
Timeline
HEDIS Abstractor
eTeam Inc, Optum Health United Healthcare
10.2023 - 02.2024
Patient Care Manager/ Care Coordinator/ Medical Assistant / HEDIS Specialist
Osceola Community Health Services
03.2021 - 03.2025
Patient Care Coordinator / CCM Care Manager
TimeDoc Health
06.2019 - 01.2021
Youth Care Worker
AB Staffing Solutions
11.2018 - 05.2019
Patient Services Representative
Medassist, A Firstsource Company
03.2018 - 06.2018
Patient Scheduling Coordinator
American Health Connections
01.2017 - 06.2017
Front Desk/Medical Assistant
Heartwell Diagnostics
09.2014 - 07.2016
Front Desk/Medication Assistant
The Kidney Treatment Center
04.2014 - 08.2014
Medical Assistant (Externship)
ABC Pediatrics
04.2013 - 02.2014
Operations Manager
Mad Financials LLC
06.2007 - Current
Bachelor's - Psychology
Keiser University
Associates - General Studies (Psychology Concentration)
Keiser University
Diploma - Medical Assistant Technician
Florida Career College