Natalie Rojas
West Covina,CA
Summary
Professional Summary
Detail-oriented and experienced Case Manager with a strong background in conducting thorough investigations and preparing comprehensive reports in compliance with federal standards and regulations. Proven ability to manage and coordinate complex cases across diverse geographic areas, including traveling to employment, residence, and educational institutions. Adept at evaluating sensitive information, adhering to legal and regulatory requirements, and ensuring accurate documentation. Known for exceptional organizational skills, attention to detail, and the ability to work independently to deliver high-quality investigative reports.
Overview
12
12
years of professional experience
Work History
Resource Manager
Insight Global
05.2022 - 05.2024
- Reviewed and approved weekly contractor timesheets; facilitated onboarding meetings for new hires to ensure smooth integration
- Managed the Account Manager’s calendar, including scheduling appointments, meetings, and travel arrangements to maintain operational efficiency
- Acted as a liaison between internal teams and external stakeholders, ensuring clear communication and project alignment
- Maintained strong relationships with consultants through regular check-ins and project updates, enhancing client satisfaction
- Addressed and resolved contract issues promptly to ensure project continuity
- Improved satisfaction scores by implementing a follow-up system with consultants every 6-12 weeks
- Hired, developed, and trained staff; set goals; conducted performance reviews; and managed salaries, contributing to team productivity
- Organized and led client meetings to review project progress, address concerns, and set future objectives
- Enhanced internal processes to increase efficiency in account management operations
- Maintained detailed records of account activities, ensuring accurate invoicing and tracking attrition
- Traveled to client sites to support project needs and strengthen relationships.
Consultant Coordinator
Insight Global Headquarters
11.2021 - 05.2022
- Managed vaccine mandate compliance and streamlined internal processes through effective liaison with internal teams and stakeholders
- Verified consultant information using Vendor Management Systems (VMS) and produced daily reports on vaccination status
- Assisted HR and Compliance teams with managing exemptions and accommodations, ensuring regulatory adherence
- Produced weekly status reports for account management, providing clear insights into project progress.
Case Manager
Insight Global - Cherokee Federal Nation
06.2021 - 10.2021
- Conducted initial intake assessments for unaccompanied minors, documenting needs and circumstances accurately
- Developed and implemented service plans, coordinating access to financial aid, legal support, medical care, and mental health counseling
- Managed a diverse caseload, providing consistent support to address unique needs and facilitate well-being
- Interviewed youths and potential sponsors, conducted background checks, and coordinated fingerprint appointments to expedite case resolution
- Presented high-risk cases to the Department of Health and Human Services, providing detailed reports and recommendations.
Eligibility Specialist
Altamed Health Services
02.2016 - 06.2021
- Verified insurance benefits using Medical, Medicare, and Commercial websites to ensure accurate coverage determination and reduce claim denials
- Scheduled and managed patient appointments, enhancing patient experience and gathering necessary information
- Reviewed and verified patient diagnosis codes for accuracy, ensuring proper billing and compliance
- Processed insurance claims, facilitated timely reimbursements, and managed financial records
- Served as a liaison between patients and insurance companies, resolving issues and improving communication
- Generated and analyzed monthly productivity reports for the Revenue Cycle Management (RCM) team
- Trained and mentored new employees on NextGen and Epic software, improving team efficiency
- Monitored and integrated updates to CPT and ICD-10 codes to ensure compliance with industry standards
- Coordinated and managed events and meetings using Microsoft Outlook.
Quality Control and Data Entry Specialist
Altamed Health Services Corporation
03.2012 - 02.2016
- Verified insurance eligibility and benefits through Medi-Cal and Medicare portals, ensuring accurate patient coverage information
- Rectified data entry errors to prevent billing discrepancies and avoid chart duplication, maintaining data accuracy
- Processed charge tickets daily using NextGen and Epic systems, supporting streamlined billing operations
- Analyzed provider documentation to accurately interpret patient diagnoses and treatment plans, enhancing data quality
- Completed CMS-1500 Forms for CHLA clinics, ensuring proper documentation and adherence to regulatory requirements
- Maintained and updated patient information to ensure accuracy and reliability of records
- Coordinated and organized events and meetings, improving organizational communication and efficiency
- Monitored and integrated updates to CPT and ICD codes to stay compliant with industry standards and changes.
Education
Bachelor of Science in Criminal Justice and Criminology -
University of La Verne
La Verne, CA12.2020
Medical Billing and Coding Certification -
Cal State LA
Los Angeles, CA12.2015
Skills
- Project Planning & Scheduling
- Resource Management
- Stakeholder Communication
- Risk Management
- Budget Management
- Process Improvement
- Microsoft Office Suite
- Spreadsheet Management
Timeline
Resource Manager
Insight Global
05.2022 - 05.2024
Consultant Coordinator
Insight Global Headquarters
11.2021 - 05.2022
Case Manager
Insight Global - Cherokee Federal Nation
06.2021 - 10.2021
Eligibility Specialist
Altamed Health Services
02.2016 - 06.2021
Quality Control and Data Entry Specialist
Altamed Health Services Corporation
03.2012 - 02.2016
Bachelor of Science in Criminal Justice and Criminology -
University of La Verne
Medical Billing and Coding Certification -
Cal State LA
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