Melanie Morales
Albuquerque,NM
Summary
Compassionate Patient Services Coordinator known for maintaining high productivity levels and completing tasks efficiently. Skilled in patient communication, appointment scheduling, and medical records management. Excel at empathy, problem-solving, and teamwork, ensuring smooth operations and positive patient experiences.
Overview
13
13
years of professional experience
Work History
Patient Service Coordinator
CenterWell Home Health
Albuquerque, NM
09.2024 - 02.2025
- Manages schedules for all patients. Edits schedule for agents calling in sick, ensuring patients are reassigned timely. Updates agent unavailability in worker console.
- Initiates infection control forms as needed, sends the HRD the completed “Employee Infection Report” to upload in the worker console.
- Serves as back up during the lunch hour and other busy times including receiving calls from the field staff and assisting with weekly case conferences. Refers clinical questions to Branch Director as necessary.
- Maintains the client hospitalization log, including entering coordination notes, and sending electronic log to all office, field, and sales staff.
- Completes requested schedule as task appears on the action screen. Ensures staff are scheduled for skilled nurse/injection visits unless an aide supervisory visit is scheduled in conjunction with the injection visit.
- Completes requested schedules for all add-ons and applicable orders:Schedules discharge visit / OASIS Collection or recert visit following case conference when task appears on action screen.
Schedules TIF OASIS collection visits and deletes remaining schedule.
Reschedules declined or missed (if appropriate) visits.
Processes reassigned and rescheduled visits.
Ensures supervisory visits are scheduled.
- Runs all scheduling reports, including the Agent Summary Report and the Missed Visits Done on Paper Report.
- Prepares weekly Agent Schedules. Performs an initial review of the weekly schedule for productivity, geographic issues, and forwards the schedule to the Branch Director for approval prior to distribution to staff.
- Verifies visit paper notes in the scheduling console as needed.
- Assists with the internal transfer of patients between branch offices.
- If clinical, receives lab reports and assesses for normality, fax a copy of the lab to the doctor, make a copy for the Case Manager, and route it to the Medical Records Department. Initiate Employee/Patient Infection Reports as necessary.
- If clinical, you may be required to perform patient visits and/or participate in on-call rotation.
- Manage referral intake.
- Update the Excel pending log, and whiteboard.
- Run the morning meeting with the team to go over all pending referrals.
- Answer calls.
HEALTHCARE SCHEDULER
Banner Health
Tucson, AZ
07.2020 - 06.2024
- Assisted customers with selecting an appropriate time for their appointment based on their individual needs
- Developed strategies for streamlining the scheduling process to maximize efficiency
- Adjusted existing appointments as needed due to changes in availability or customer preferences
- Answer up to 100 phone calls daily
- Collect demographic data at the time of scheduling appointments
- Send triage messages to multiple and appropriate clinical staff
- Schedule appointments according to new and established guidelines
- Generate and communicate new ideas and suggestions to improve quality of service
- Achieve appointment-setting goals by meeting objective and metrics
- Trained new employees on proper use of organization's products and systems
- Conducted one-on-one coaching sessions with new employees to develop their skills and knowledge
- Evaluated current processes used for onboarding new hires and proposed recommendations for improvement based on identified areas of need
- Assessed the effectiveness of training programs and identified areas of improvement
COPAY TEAM
OptumRx
Tucson, AZ
05.2017 - 04.2020
- Reviewed customer requests, resolved questions and defined specifications before completing orders
- Verified client information and validated data before creating shipping paperwork and internal documents
- Responded to telephone inquiries and provided information about order status, store hours and pharmacy procedures
- Helped pharmacy staff prepare medications and fill orders
- Trained new pharmacy staff in procedures and customer service standards
INSURANCE SPECIALIST
UnitedHealthCare
Abluquerque, NM
08.2015 - 05.2017
- Advised clients on available resources and services offered through the program
- Provided excellent customer service to Medicaid beneficiaries, ensuring their needs were met promptly and accurately
- Utilized computer systems to process applications for Medicaid benefits in a timely manner
- Evaluated customer account information to assess current issues and determine potential solutions
- Contact providers offices to schedule appointments, and request prior authorizations for medications for procedures
- Managed patient billing
- Managed Medicaid benefits for the State of New Mexico
- Experience with Commercial plans, Medicaid plans, Medicare plans, VA plans, and workers comp
- Order ID cards, Eob's (explanations of benefits), plan formularies and other requested member material
- Reach out to local pharmacies to determine a claim rejection
- We basically took care of any needs a patient would have in regards to their health care coverage, we advocated for our patients and took out all the work for them to make life just a littler easier
- Really well at multi-tasking
ONWER/OPERATOR
JCubed Concepts
Albuquerque, NM
04.2014 - 05.2017
- Thoroughly cleaned commercial buildings, including rooms, lobbies, lounges and restrooms to maintain organized and welcoming environment
- Disposed of trash, cleaned and organized areas and maintained supply inventory
- Handled, mixed and stored chemical cleaners in compliance with safety requirements and standard operating procedures
- Completed hourly custodial rounds, including floor sweeping and vacuuming, glass entryway cleaning and trash collection
SALES ASSOCIATE
Russell Cellular
Bernalillo, NM
07.2012 - 01.2013
- Greeted customers warmly and offered assistance
- Helped customers find and select products
- Kept work area clean, organized and free of clutter at all times
- Assisted customers with product selection to ensure customer satisfaction
- Organized merchandise displays to promote higher levels of customer engagement
- Operated cash register and POS to process sales transactions and handle payments
- Provided accurate information about products, prices and availability both in person and over the phone
- Tagged new merchandise for sale and updated signs
Education
GED -
Centeral New Mexico Community College
New Mexico01.1999
Skills
- Customer Service
- Schedule Coordination
- Documentation Expertise
- Medical Terminology
- Data Entry
- Order Processing
- Microsoft Office
- Microsoft Teams
- Microsoft Word
- Outlook
- Insurance Verification
- Effective Multitasking
- Excel
References
References available upon request
Timeline
Patient Service Coordinator
CenterWell Home Health
09.2024 - 02.2025
HEALTHCARE SCHEDULER
Banner Health
07.2020 - 06.2024
COPAY TEAM
OptumRx
05.2017 - 04.2020
INSURANCE SPECIALIST
UnitedHealthCare
08.2015 - 05.2017
ONWER/OPERATOR
JCubed Concepts
04.2014 - 05.2017
SALES ASSOCIATE
Russell Cellular
07.2012 - 01.2013
GED -
Centeral New Mexico Community College
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