MANUEL N PARRA

• Provided emotional support for clients during difficult times such as illness or the loss of a loved one, helping them cope effectively with life''s challenges.
• Promoted independence among clients by teaching self-care skills such as grooming or light housekeeping tasks within their capabilities.
• Maintained accurate records of client progress, ensuring timely updates to care plans and communication with families.
• Assisted clients in enrolling them in Medi-cal and Medicare.

Executed the day-to-day business processes required to support the delivery of critical health services: application intake, eligibility determination, enrollment processing to Center for Medicare and Medicaid Services, daily analysis of transaction reporting and validation of member materials.

• Processed inbound Enrollment documentation: applications, creditable coverage attestation, disenrollment request, premium payments; investigating and researching potential invalid requests received by the plan and CMS alignment

• Supervised the team to improvement, satisfaction and learning to serve at the highest level of competency

Telesales role. Responsible for taking and making telephone calls with prospective members with the intent to educate them on benefits of Molina products and conducted enrollment into product of choice over the phone or other sales enrollment channel desired. Strong working knowledge and licensed for Medicare in 17 states and other government health programs/income assistance programs.

• Worked with senior citizens and low-income individuals in a tele-sales environment and enrollment. • Managed with strong telephonic skills CMS marketing regulations and enrollment in 17 states
• Conducted presentations in approved guidelines, needs analysis and cost benefit analysis

Assist patients in enrolling in programs like Medi-Cal (both fee-for-service and managed care plans), Medicare, Covered California, private HMO and PPO plans, Ryan White, ADAP/PrEP-AP, drug manufacturer patient assistance programs, sliding fee scale and CalFresh. Strong knowledge of medical terminology . Fluent in written and spoken Spanish and English . knowledge in Microsoft Office programs. Advanced knowledge in insurance plans.

• Reviewed statistic enrollment data and prepared reports.
• Updated, entered and reviewed customer data using PointCare.
• Understood and thoroughly explained services provided to customers and potential customers.
• Communicated effectively via telephone, email and in person with prospective customers.
• Communicated with people from various cultures and backgrounds on application process.
• Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
• Developed extensive fact-checking and research skills as result of continuously reviewing different programs and options.
• Documented all communication with applicants and inputted information into system using PointCare.

• Provide education about benefits that patient may be eligible for.
• Ensure clients who express interest in PrEP get health insurance coverage.
• Enroll patients in ADAP(PrEP-AP and Gilead payment Assistance Program.
• Enroll patients in CoveredCA and assist patient with Medical-cal application.

As Patient Benefit Specialist, I worked with both insured and uninsured clients in order to gain access to clinical services, HIV/AIDS medications, and/or financial assistance to cover insurance premiums in accordance with established guidelines and regulations. I assists clients in enrolling in CoveredCA , ADAP (AIDS Drug Assistance Program), PrEP (Patient Assistance Program (PrEP-AP), AIDS Health Insurance Premium Payment (OA-HIPP), Ryan White, Medi-cal and any other services.

• I working effectively with hospital employees and patients.• Interviewing clients in a hospital setting and/or home visits to assist the clients in obtaining maximum benefit coverage.• Completion of applications for state and federal programs (including Health Exchange/Marketplace programs), Medi-cal and reviewing medical records and taking all necessary action to expedite benefit approval.
• Achieved and maintain certification designation as “Certified Application Counselor”. Screened and assisted patients in applying for Social Security Disability by helping patients apply online. Maintained ongoing communication with government agencies regarding the status of claims.

• Help reach and enroll customer in need of health insurance coverage
• Assist consumers in receiving eligibility determinations working with consumers to help them complete the Covered California application and select and enroll in a health insurance plan in either Covered California's individual market or through its Small Business Health Options Program (SHOP) marketplace.
• Providing impartial information about a consumer's plan choices, and offer advice about which particular plan may best meet a consumer's needs.
• Provides detailed analysis that identifies and promotes the value of heath plan, discuss options, provides alternative plan options when appropriate and makes recommendations. 

• Work effectively with hospital employees and patients. Interviewing clients in a hospital setting and/or home visits to assist the clients in obtaining maximum benefits coverage.
• Completion of applications for state and federal programs (including Health Exchange/Marketplace programs), Medi-cal, SSI, SSA and reviewing medical records and taking all necessary action to expedite benefit approval. 

• Handle inbound disconnect/downgrade calls from existing customers Responsible for skillfully retaining customers through positive customer relationship 
• Identify reason(s) for disconnect and overcome objections in an effort to retain the customer 
• Save and re-sell the value of our products and services by properly aligning their features, benefits and price with the needs of our customers 
  

• Greeting clients in a personalized, friendly, and inviting manner.
• Matching clients with the best suited tax professional for their needs. 
• Scheduling clients how they would like to be scheduled. 
  

• Works directly with clients and employees to answer questions and resolve their enrollment and termination issues. 
• Acts as a liaison with insurance carriers to resolve claims issues. Provides assistance with the appeal process. 
• Answers questions relating to legislation and benefit laws regarding HIPAA, COBRA, and FMLA.
• Meets all new key contacts at least once to build solid relationship and meets existing contacts as needed to further enhance relationship.
  
• Do presentations during open enrollment to educate employees on choosing the best health plans based on their needs.

• Taking incoming calls and recording all information accurately Performing data entry for each phone call 
• Create and distribute schedules for all on-call doctors & physicians 
• Following up with all phone calls to ensure that emergencies are tended to and requirements completed Maintain patience on all phone calls, as they can range from short to long conversations
  

• Supervise work activities of cleaning personnel to ensure clean, orderly, and attractive rooms at the hotel.
• Assign duties, inspect work, and investigate complaints regarding housekeeping service and equipment and take corrective action. 
• Purchase housekeeping supplies and equipment, take periodic inventories, screen applicants, train new employees, and recommend dismissals.