Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic

Nataly Flores

Sylmar,California

Summary

I am enthusiastic to work my way for a new future and all the new possibilities towards my new career. I am reliable, dependable, on-time, able to work under pressure, and go above and beyond what is expected to be done. I know if you give me an opportunity to work for you, I can be a valuable asset to your company. I thank you for reviewing my resume and look forward to an opportunity for an interview

Overview

5
5
years of professional experience

Work History

Program Coordinator

Tender Touch Homecare
04.2021 - 06.2023
  • Assisting clients with behavioral issues
  • Teaching children and adults with disabilities
  • Working in clients homes
  • Delivering what clients want and needs
  • Coordinating plans for each individual client
  • Developed and maintained relationships with external partners to facilitate program operations.
  • Scheduled and supervised staff meetings to discuss new ideas and update participants on program details and milestones.
  • Created and delivered program training and education to keep participants knowledgeable about program and provide necessary skills to participate productively.
  • Kept program-related data accurate, up-to-date and easily accessible for accessibility.
  • Analyzed program data by tracking and reporting program outcomes to identify areas of improvement.

Benefit Auditor

Maximus EDD
07.2022 - 05.2023
  • Fact-finding
  • ER pro/ DEF pro
  • Unemployment and State Disability Insurance
  • Audit and collect payroll taxes of companies and businesses
  • Maintain employment records for millions of California workers
  • Gather, analyze, and publish information
  • Systems: CUBS/ Otech/ Sharepoint/ AWS/ Outlook/ VCC/ UIB desktop/ EDD portal/ Microsoft Teams/ Fieldglass/
  • Authenticator/ MobilePass+
  • Followed established auditing processes to meet internal and regulatory requirements.
  • Analyzed data and findings to prepare reports detailing financial information.
  • Performed observations and evaluated supporting documents to supplement audit findings.

Behavioral Coordinator

Autism Learning Partners
01.2020 - 12.2021
  • Working in clients homes
  • Delivering what clients want and needs
  • Coordinating plans for each individual client
  • Conducted functional behavior assessments, functional analysis, preference assessments, and assessments of basic learning and language skills to identify target behaviors and purpose of behaviors.
  • Implemented and established behavior strategies by setting rules, reiterating expectations, and rewarding good behavior.
  • Used [Software] to document patient information, progress notes, and treatment plans.
  • Created progress reports, assessments and charting within required timeframes.

Appeals and Grievances Coordinator

HealthNet Of California
07.2021 - 07.2021
  • Coordinator
  • Speaking to clients to help with their claim issues
  • Tracking/Trending of all grievances, appeals, and complaints received within the Member Services Department
  • Accessibility/Timeliness of appointments, Quality of Service
  • Writing disputes or concerns about initial determinations; primarily concerns related to denial of services or payment for services reviewing the decision previously made or re-hearing the employee's complaint.
  • Provided outreach for additional information for appeals and grievances.
  • Processed and finalized appeals and grievances within agreed-upon turnaround time.
  • Submitted verbal and written notification to members and providers.

Medical Biller

JZ Billing
01.2020 - 12.2020
  • Dealing with Personal Injury Appeals
  • Dealing with Insurance claims
  • Finding IDC-10 and CPT codes on Doctors notes
  • Following HIPAA guidelines
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Verified insurance of patients to determine eligibility.
  • Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
  • Posted payments and collections on regular basis.
  • Reviewed patient records, identified medical codes, and created invoices for billing purposes.
  • Reviewed patient diagnosis codes to verify accuracy and completeness.
  • Prepared billing statements for patients and verified correct diagnostic coding.

Supervisor

Allstate Maintenance
12.2018 - 08.2020
  • Answer/return calls, take messages and set appointments
  • Prioritize workloads and ensure all paperwork is complete
  • Guarantee customer/client satisfaction
  • Solicited orders for goods or services over the telephone
  • Delivered prepared orders and inventory
  • Persuaded potential customer to purchase a product or service
  • Coordinating events and plans
  • Scheduling and appointment setting
  • Bookkeeping
  • Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
  • Handled customer complaints, resolved issues, and adjusted policies to meet changing needs.
  • Mentored newly hired employees on operating equipment and safety and developed training manual to use for reference.

Education

SOCHI - Medical Billing And Coding

Southern California Health Institute
08.2019

High School Diploma -

San Fernando High School
06.2015

Skills

  • 42 wpm
  • Strong multitasking abilities
  • Photocopying and scanning abilities
  • Microsoft Office Computer skills
  • Excel (graphs, equations, chart, functions, and Macros)
  • Determined to meet deadlines
  • Strong organizational ability
  • Efficient time-management skills
  • On time and reliable
  • Energetic work attitude
  • Professional communication skills
  • Able to work under pressure
  • Amazing team player
  • Fast Learning
  • Laws and Regulations
  • Computer proficiency
  • Leadership experience
  • Problem-solving abilities
  • Medical Terminology
  • Health Insurance Models
  • Group vs Individual plans
  • HIPAA knowledge
  • Knowledge of Medicaid & Medicare
  • Knowledge of Medi-cal claims
  • Project Coordination
  • Systems Analysis

Languages

Spanish
Limited Working

Timeline

Benefit Auditor

Maximus EDD
07.2022 - 05.2023

Appeals and Grievances Coordinator

HealthNet Of California
07.2021 - 07.2021

Program Coordinator

Tender Touch Homecare
04.2021 - 06.2023

Behavioral Coordinator

Autism Learning Partners
01.2020 - 12.2021

Medical Biller

JZ Billing
01.2020 - 12.2020

Supervisor

Allstate Maintenance
12.2018 - 08.2020

SOCHI - Medical Billing And Coding

Southern California Health Institute

High School Diploma -

San Fernando High School

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Nataly Flores