Merlyn Pavon Garcia
Bakersfield,USA
Summary
Patient-oriented Case Management Assistant, Medical Receptionist, Medical records and Call Center experience and with strong attention to detail, professional telephone etiquette and organization skills.
Overview
11
11
years of professional experience
Work History
Case Management Assistant
Universal Healthcare MSO LLC
07.2024 - Current
- Assist members with appointment scheduling, following up on pending referrals, requesting refill on medications assisting with transportation, and other care coordination needs.
- Work collaboratively with Nurse Case Managers and Social Services staff on care coordination, member follow-up, communication with agencies.
- Supporting our members experiencing transitions of care by assisting case managers with coordination of post-discharge needs, follow-up appointments, and transportation.
- Provided administrative support, including answering phones for Fresno and Kern County assisting with correspondence, filing, scanning, and maintaining department data systems.
- Assist with training and orientation of new staff, as requested.
- Report and escalate member concerns, variances, or changes in condition to the appropriate care team members to ensure timely intervention and coordinated follow-up.
Medical Receptionist
Clinica Sierra Vista
11.2023 - 07.2024
- Welcomes and greets patients/ visitors to the department in a manner that is helpful and friendly; determines purpose of visit and direct patients/visitors to appropriate person or department(s)
- Check's in and registers patients upon arrival
- Assists in coordination of patient flow to allow the clinic to serve an adequate number of patients as established by grant requirements
- When scheduling appointment(s), carefully screens patients for required demographics, and can identifies new and established patient visits based on the Clinica Sierra Vista scheduling policy
- Informs patient of any existing balance noted in computer during registration and educate on future balances and financial responsibility for services rendered
- Provides information to Clinic callers according to the Clinic's Policies and Procedures; transfers calls as needed
- Must exercise utmost diplomacy and tact to provide excellent customer service for patients, practices confidentiality and privacy protocols in accordance to Clinic policies and HIPAA requirements
- Verifies method of payment for service ( Medi-Cal , Medicare, private insurance, private pay, Healthy Families, etc.) and collects data and/or co-payment as appropriate
- Completes daily batch reports and cash collections drop following daily operations and ensures reports are forwarded appropriately and timely to accounts receivable
- Exercises problem-solving and conflict resolution skills when handling patient complaints; refers patient complaints to appropriate designated personnel as needed
- Performs day-to-day administrative functions and general office duties including but not limited to word processing, copying, filing, faxing, answering phones and data entry
- Performs all duties in support of successful EHR/EPM utilization.
Call Center Representative
Clinica Sierra Vista
01.2020 - 01.2023
- Answers calls for multiple locations in Kern County and Fresno using Talk desk and Epic System
- Answer and return calls in the order that they are received
- Identifies, research and resolve patient issues, manages difficult or emotional patient situations
- Responds promptly to patient needs
- Document clearly and informatively and route to appropriate pools or sites
- Assisted patients with medication request, medical records request, forms needed signed request
- Faxed over any orders needed for patients to Quest, Kern radiology or any places referred to
- Bilingual speak clearly and persuasively in positive or negative situations
Medical Receptionist
Clinica Sierra Vista
12.2018 - 01.2020
- Organized paperwork such as charts and reports for office and patient needs
- Completed skilled administrative work to support all office staff and operational requirements
- Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing
- Responded to correspondence from insurance companies to verify patient's coverage
- Assign other receptionist to a provider to pre-register, verify and confirm appointments for the month
- Attend RPIW's with practice manager to share and implement ideas for better workflow in the whole organization
- Adhered to strict HIPAA guidelines at all times to protect patient privacy
- Promptly answered calls using CISCO phone system and greeted callers enthusiastically
- Scheduled, rescheduled and handled cancelled appointments for patients
- Scheduled appointments for doctor visits and procedures using EPIC
- Obtained payments from patients and scanned identification and insurance cards
- Improved timely payment of bills by developing flexible payment plans for patients
- Placing patients on a sliding scale
- Received, recorded and addressed incoming and outgoing communication via telephone and email
- Frequently double-checked patient histories and current information while scheduling follow-up appointments.
Dental Receptionist
Western Dental & Orthodontics
10.2017 - 06.2018
- Assisted patients in completing all necessary forms and documents
- Maintained and managed patient records in compliance with security regulations
- Scheduled, rescheduled and handled cancelled appointments for patients using E-Clinical's system
- Always adhered to strict HIPAA guidelines to protect patient privacy
- Pulled paper charts for patients a day before to pre-register for appointments and call to verify eligibility.
Medical Receptionist
Kern Pediatrics
01.2017 - 06.2017
- Check in and schedule appointment using E-clinicals
- Always adhered to strict HIPAA guidelines to protect patient privacy
- Responded to correspondence from insurance companies to verify patient's coverage
- Checked patient data including insurance, demographic and health history to ensure all information was current
- Located, checked in and pulled medical records for patient appointments and incomplete charts
- Frequently double-checked patient histories and current information while scheduling
- Appointments
- Promptly answered multi-line phone system and greeted callers enthusiastically
- Scheduled, rescheduled and handled cancelled appointments for patients
- Signed up patients for Family Pact, CDP program, Gateway.
Sales Representative
Metro PCS
03.2015 - 02.2017
- Customer locations and special events
- Developed and implemented sales strategies to increase revenue
- Built strong rapport with clients by understanding needs and clearly explaining products
- Built customer loyalty and retention by delivering excellent shopping experiences
- Accounted for all inventory and ordered new stock
- Upsold customers by recommending accessories and promotions to increase revenue.
Education
High school or equivalent - MEDICAL RECEPTION BILLING AND CODING
BRIGHTWOOD COLLEGE
Bakersfield, CAHigh School Diploma -
Golden Valley Highschool
Bakersfield Ca05.2010
Timeline
Case Management Assistant
Universal Healthcare MSO LLC
07.2024 - Current
Medical Receptionist
Clinica Sierra Vista
11.2023 - 07.2024
Call Center Representative
Clinica Sierra Vista
01.2020 - 01.2023
Medical Receptionist
Clinica Sierra Vista
12.2018 - 01.2020
Dental Receptionist
Western Dental & Orthodontics
10.2017 - 06.2018
Medical Receptionist
Kern Pediatrics
01.2017 - 06.2017
Sales Representative
Metro PCS
03.2015 - 02.2017
High school or equivalent - MEDICAL RECEPTION BILLING AND CODING
BRIGHTWOOD COLLEGE
High School Diploma -
Golden Valley Highschool