Melanie Rodriguez
St Louis Park,MN
Summary
To obtain a challenging position where I can leverage my current experience while learning new skills in order to ensure our mutual success.
Overview
20
20
years of professional experience
Work History
Financial Navigator
MHealth Fairview
07.2024 - 10.2024
- Accurate and timely screening of self-pay patients requesting an appointment with the Financial Assistance Navigation Team and/or self-pay patients.
- Went to bedside to screen Patients for Medical Assistance or MNcare programs
- Responsible for insurance and eligibility verifications and assessment of financial requirements of recommended treatment
- Also, made referrals to other social services and necessary resources
- My main tool to preform my job was Epic and Teams.
Patient Access Specialist
Allina Health
02.2017 - 06.2024
- I was a team member in the courage Kenny Rehabilitation benefits team
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Contacted insurance companies for patient medical billing operations.
- Epic was the main tool used to preform my job.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
Customer Service Representative
Medica
09.2010 - 02.2017
- This involved investigation and resolution of issues pertaining to enrollment, benefits, billing, and recovering from service failures by restoring trust and confidence through professionalism and confidence
- Responded to customer requests for products, services, and company information. Mainly on State Public Programs; MNcare and Medical Assistance.
- Promptly responded to inquiries and requests from prospective customers.
- Responded proactively and positively to rapid change.
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
Prior Authorization Representative
Express Scripts
08.2004 - 08.2010
- My role was a Prior Authorization representative consists of calls from doctors and pharmacists requesting approval for medications
- I specialized in the department of defense while maintaining an exceeding level in my quality audits.
- Tracked referral submission during facilitation of prior authorization issuance.
- Resolved patient billing inquiries and other issues efficiently.
- Processed new medication and refill requests for authorization.
Education
B.S. in Business Management -
University of Phoenix
01.2011
Skills
- Microsoft Office Suite
- Outlook
- Avaya Agent
- Epic
- Jagger
- Bilingual in Spanish
- Financial statement analysis
- Stakeholder Communication
- Due diligence
- Analytical Thinking
Languages
Spanish
Full Professional
Timeline
Financial Navigator
MHealth Fairview
07.2024 - 10.2024
Patient Access Specialist
Allina Health
02.2017 - 06.2024
Customer Service Representative
Medica
09.2010 - 02.2017
Prior Authorization Representative
Express Scripts
08.2004 - 08.2010
B.S. in Business Management -
University of Phoenix
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