Natalie Reyes
Orange,CA
Summary
Knowledgeable Specialty Referral Coordinatoor with solid background in coordinating referral processes and ensuring seamless communication between patients and healthcare providers. Demonstrated success in managing patient information and facilitating timely referrals. Proven ability to utilize organizational and multitasking skills to enhance operational efficiency.
Overview
5
5
years of professional experience
Work History
Specialty Referral Coordinator
Families Together of Orange County
07.2024 - Current
- Coordinate and process incoming and outgoing specialty referrals in accordance with clinical guidelines and insurance requirements.
- Communicate with patients to explain referral processes, provide appointment details, and answer questions.
- Obtain prior authorizations from insurance providers when required and verify patient eligibility and coverage.
- Track referral status and follow up with patients and specialists to ensure completion of appointments and documentation.
- Collaborate with physicians, nurses, and administrative staff to gather necessary clinical information and maintain workflow efficiency.
- Document referral activities accurately in the electronic medical record (EMR) system.
- Maintain confidentiality and compliance with HIPAA and other healthcare regulations.
- Identify and troubleshoot issues related to delayed referrals or authorization denials.
- Assist with data reporting and quality improvement initiatives related to referral processing.
Referral Coordinator
Serve the People Community Health Center
09.2023 - 05.2024
- Receive and process provider referrals to specialists or diagnostic services, ensuring all required documentation is complete.
- Communicate with patients regarding referral details, including appointment scheduling and preparation instructions.
- Verify insurance eligibility and benefits; obtain prior authorizations when needed.
- Work with external specialty offices to coordinate care and ensure timely appointment scheduling.
- Enter and maintain accurate information in the electronic medical record (EMR) and other tracking systems.
- Provide excellent customer service and support to patients and healthcare providers.
Customer Service Representative
CalOptima
07.2020 - 03.2023
- Responded to customer inquiries via phone and email, ensuring timely resolution of issues.
- Assisted in processing orders and tracking shipments to enhance customer satisfaction.
- Maintained accurate records in CRM system, improving data integrity and accessibility.
- Collaborated with team members to streamline communication processes for increased efficiency.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Responded to customer requests for products, services, and company information.
Education
High School Diploma -
Los Amigos High School
06.2010
Certification in Clinical Medical Assisting - undefined
Regional Occupational Program
06.2013
Skills
- Data entry proficiency
- MS office expertise
- HIPAA regulations
- Physician authorizations
- Healthcare systems
- Electronic patient charts
- Outbound calls
- Pre-authorizations
- Insurance verification
- Medical terminology
- Multi-line phone proficiency
- Medical terminology knowledge
- Referring physician communication
Languages
Spanish
Professional Working
Timeline
Specialty Referral Coordinator
Families Together of Orange County
07.2024 - Current
Referral Coordinator
Serve the People Community Health Center
09.2023 - 05.2024
Customer Service Representative
CalOptima
07.2020 - 03.2023
Certification in Clinical Medical Assisting - undefined
Regional Occupational Program
High School Diploma -
Los Amigos High School
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