Nayeli Castaneda
Pico Rivera,United States
Summary
Results-driven Managed Care Coordinator with expertise in patient outreach and service coordination. Enhances healthcare experiences through effective communication and compliance verification. Facilitates patient-provider communication and ensures compliance, driving improved service delivery and patient satisfaction.
Overview
5
5
years of professional experience
Work History
Managed Care Coordinator
Northeast Community Clinic
Alhambra
10.2024 - Current
- Facilitated communication among patients, providers, and insurance representatives to improve service delivery.
- Managed credentialing processes for healthcare providers and facilities to ensure compliance.
- Reviewed and verified provider applications and supporting documents for accuracy.
- Created and maintained spreadsheets to track managed care activities, including contract expirations and renewals.
- Outreached to senior patients to assist with scheduling medical appointments efficiently.
- Communicated effectively with medical staff regarding credentialing status updates.
- Assisted senior members with primary care physician changes as needed.
Enrollent Specialist
Via Care Community Health Center
Los Angeles, California
09.2023 - Current
- Assisted patients with Medi-Cal applications and case management to ensure access to necessary services.
- Guided patients in selecting appropriate Medi-Cal health plans, improving their healthcare options.
- Screen patient to see what medical coverage they qualify for.
- Facilitated primary care provider changes for patients, enhancing alignment with their healthcare needs.
Customer Service Representative
Bank Of America
Brea, CA
02.2021 - 07.2023
- Answered constant flow of customer calls with minimal wait times.
- Handled customer inquiries and suggestions with professionalism to enhance customer satisfaction.
- Clarified customer issues and determined root cause of problems to resolve product or service complaints.
- Educated customers about billing, payment processing and support policies and procedures.
- Updated account information to ensure accurate customer records.
- Tracked customer service cases and updated service software to streamline information retrieval.
Education
High School - General
Montebello Adult Schools
Montebello, CA06.2013
Medical Assistant -
UEI
El Monte, CA05.2010
Skills
- Medicaid enrollment
- Patient outreach
- Compliance verification
- Service coordination
- Health plan selection
- Data organization
- Attention to detail
- Time management
- Strong organization
- Effective communication
- Problem solving
- Administrative support
Languages
English
Professional
Spanish
Professional
Timeline
Managed Care Coordinator
Northeast Community Clinic
10.2024 - Current
Enrollent Specialist
Via Care Community Health Center
09.2023 - Current
Customer Service Representative
Bank Of America
02.2021 - 07.2023
High School - General
Montebello Adult Schools
Medical Assistant -
UEI