Carlos Ortiz
Los Angeles,CA
Summary
Dynamic healthcare professional with a proven track record at Maximus Inc., excelling in patient care coordination and insurance authorizations. Expert in leveraging bilingual capabilities to enhance patient communication and streamline processes. Demonstrated leadership in team development, achieving significant improvements in patient registration efficiency.
Overview
23
23
years of professional experience
Work History
Assistant Leasing Agent
Avenue5 Residential
06.2024 - Current
- Manage a 140-unit property with long-term and short-term tenants
- Performs all sales and leasing activities to achieve the community’s revenue and occupancy goals by greeting and qualifying prospects, conducting community tours and showing apartments
- Contribute to property revenue by effectively marketing available units, conducting tours, and closing lease agreements
- Enhance resident satisfaction by providing exceptional customer service, addressing concerns promptly and fostering positive relationships
- Coordinated any build-out needs by working with contractors, securing city permits, and coordinating materials throughout project execution, serving as a point of contact for multiple stakeholders
Business Owner
Phuz3D Dance Collective, LLC
01.2020 - Current
- Daily operations including human resources, finances and accounting, maintenance, and materials management
- Contract negotiations, including real estate, large community and non-profit events, high-profile media, and entertainment events
- Choreography development, and dance instructor
Patient Relations Representative
PeaceHealth
03.2022 - 05.2024
- Transcribe all incoming referral and diagnostic orders in a high-volume Gastroenterology clinic
- Obtain prior authorization approvals for all incoming referrals, diagnostic procedures, and surgeries
- Create new patient accounts and perform data entry for demographics, insurance, and authorizations
- Cross-reference and update patient information from Care Everywhere
- Serve as liaison between referring providers, insurance carriers, and patients
- Coordinate record requests for external facilities and organizations
- Perform data entry with records received
- Coordinate care to help navigate patients through the healthcare system
- Schedule new patient consultations and direct access screenings
- Schedule Gastroenterology diagnostic procedures
- Manage incoming referral work queue averaging more than 500 new orders/week
- Perform adhoc tasks/project designated by leadership
Intake Specialist
Signature Home Health
12.2019 - 04.2020
- Process physician referral orders to initiate homecare for patients
- Audit referral and intake order to ensure they meet compliance criteria
- Coordinate patient’s care and schedule admission appointments with multidisciplinary team
- Perform referral and insurance authorizations
- Perform as liaison between patient, care team/provider, and insurance
Pre-Certification Associate
Hollis Cobb Associates/Emory University
08.2016 - 12.2019
- Precept employees on the use of the State of Georgia’s Medicaid web portal
- Complete insurance prior-authorizations for surgery, procedures, and post-op appointments
- Assist patient with submitting insurance denial appeals
- Coordinate patient care between care team, insurance, and billing departments
Medicaid Coordinator/Patient Care Coordinator
Georgia Urology
06.2014 - 08.2016
- Pre-certify insurance authorization for surgical specialists and radiology team for all Medicaid pediatric patients
- Track and monitor referral and insurance authorizations
- Front office intake and patient registration
- Schedule office visits
- Cash registrar and bank deposits
- Coordinate patient care between care team, insurance, and billing departments
Bi-Lingual Medical Service Clerk
Fetter Health Care Network
04.2010 - 06.2014
- Front office intake and patient registration
- Schedule office visits
- Cash registrar and bank deposits
- Provide translation services between patients, family members, and provider
- Patient care coordination, and advocacy to assist patient navigation through healthcare system
Fully Insured New Business Processor
Meritian Health
07.2006 - 02.2009
- New patient registration and insurance verification
- New business accounts for various organizations
- New employee insurance ledgers
- Track supply requests and mail correspondence
Enrollment Counselor / Data Analyst
Maximus Inc. (N.Y.M.C.)
08.2001 - 09.2005
- Client services educator and customer service relations
- Patient insurance dis/enrollment and registration
- Insurance claim audits, and data analysis
- Bi-lingual client/patient translator
Education
Associate of Arts -
MONROE COLLEGE
New York01.2005
Skills
- Insurance Authorization and claims
- Referral Coordination
- Patient Registration
- Patient Care Coordination
- Epic EMR experience
- Team development and training
- Bilingual (English/Spanish)
- Microsoft Office suite
- Leadership
Timeline
Assistant Leasing Agent
Avenue5 Residential
06.2024 - Current
Patient Relations Representative
PeaceHealth
03.2022 - 05.2024
Business Owner
Phuz3D Dance Collective, LLC
01.2020 - Current
Intake Specialist
Signature Home Health
12.2019 - 04.2020
Pre-Certification Associate
Hollis Cobb Associates/Emory University
08.2016 - 12.2019
Medicaid Coordinator/Patient Care Coordinator
Georgia Urology
06.2014 - 08.2016
Bi-Lingual Medical Service Clerk
Fetter Health Care Network
04.2010 - 06.2014
Fully Insured New Business Processor
Meritian Health
07.2006 - 02.2009
Enrollment Counselor / Data Analyst
Maximus Inc. (N.Y.M.C.)
08.2001 - 09.2005
Associate of Arts -
MONROE COLLEGE
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