Summary
Overview
Work History
Education
Skills
Timeline
Generic

MAYRA CALDERON

Miami,FL

Summary

Skilled Referral Coordinator with 9 years of experience managing provider referrals. Recognized for effectively communicating with stressed patients, alleviating concerns and ensuring full satisfaction. Thrive in a high-volume call center environment, while maintaining accuracy and quality service.

Overview

10
10
years of professional experience

Work History

Utilization Management Coordinator

Solis Health Plans
05.2025 - Current
  • Provide timely data entry referrals for continuing care as necessary.
  • Refers all services requiring prior authorization to Um Nurse as appropriate.
  • Maintain patient confidentiality
  • Handle inbound calls and answer provider question.

Referral Supervisor of Central Florida

Clinical Care Medical Centers (formerly Conviva Care Centers)
04.2023 - Current
  • Monitor daily activities to ensure referrals are processed accurately and timely.
  • Keep staff informed about any changes in procedures, policies, or regulations.
  • Review referral data and staff performance to identify areas for improvement.
  • Solve any issue that arises during the referral process.

Referral Coordinator

MBMG Medical Centers (formerly Clinical Care Medical Centers)
12.2015 - 04.2023
  • Scheduled patients according to availability, urgency, and insurance authorization guidelines.
  • Used computerized Resource and Patient Management System (RPMS) AND Electronic Health Record (EHR) system.
  • Documented services and collected required data for evaluation.
  • Improved operation by working with team members and customers to create a good work environment.
  • Self-motivated and committed to achieve best results.
  • Knowledge of ICD 10 and CPT coding.
  • Demonstrate respect for the privacy and confidentiality of patient’s protected health information.
  • Proficient with medical terminology.
  • Excellent professional communication abilities, at all levels within the organization and with patients all the time.

Education

High School Diploma -

01.2001

CPC-A - undefined

AAPC Medical Billing & Coding
Miami, FL
04.2023

English - undefined

Miami Dade College
Miami, FL
12.2016

Skills

  • Knowledge of basic medical terminology and keyboarding skills
  • Ability to respond effectively under stress
  • Ability to function independently with minimal supervision within the scope of knowledge and authority of the position
  • Detail oriented with the ability to enter information accurately on paper and into electronic systems
  • Excellent organizational skills and attention to detail
  • Ability to demonstrate professionalism
  • Excellent time management skills including the ability to multitask and prioritize in a fast-paced environment
  • Excellent written and oral communication skills with the ability to communicate effectively with colleagues

Timeline

Utilization Management Coordinator

Solis Health Plans
05.2025 - Current

Referral Supervisor of Central Florida

Clinical Care Medical Centers (formerly Conviva Care Centers)
04.2023 - Current

Referral Coordinator

MBMG Medical Centers (formerly Clinical Care Medical Centers)
12.2015 - 04.2023

CPC-A - undefined

AAPC Medical Billing & Coding

English - undefined

Miami Dade College

High School Diploma -

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