NAYELY RUBY ORTEGA
Los Angeles
Summary
Highly-motivated Care Coordinator looking for a position in a challenging healthcare center to focus on providing patients with the highest levels of medical care to ensure that their medical and comfort needs are met
Overview
9
9
years of professional experience
Work History
Appointment Coordinator
Gardena Dental Group
Gardena
08.2024 - 03.2025
- Adhered strictly to HIPAA guidelines when handling confidential health information.
- Ensured that all necessary paperwork was completed prior to scheduled appointments.
- Reviewed daily schedule for accuracy and completeness prior to start of day's activities.
- Verified insurance eligibility for all patients prior to scheduling appointments.
- Coordinated and scheduled patient appointments with physicians and other healthcare providers.
- Contacted referring physicians offices as needed to obtain additional information about referred patients' needs.
- Developed and implemented strategies to improve customer satisfaction levels.
- Provided information to patients on available appointment times and clinic policies.
- Prepared various reports summarizing daily, weekly, monthly, and quarterly activity related to appointment scheduling.
- Worked closely with front office staff regarding patient registration issues related to appointment scheduling.
- Maintained up-to-date records of patient appointments in the electronic medical system.
- Answered phone calls, emails, and other inquiries from patients regarding appointment scheduling.
- Researched solutions for complex problems associated with appointment scheduling.
- Provided general clerical support such as filing, faxing, copying documents.
- Assisted in resolving conflicts with conflicting schedules or double bookings.
- Processed payments for co-pays at time of service according to established protocols.
- Collaborated with clinical teams in order to provide timely access for new referrals.
- Responded promptly to any changes or cancellations of existing appointments.
- Managed a high volume of incoming requests while maintaining quality customer service.
- Confirmed with customers about appointments and rescheduled missed appointments.
- Performed various administrative work.
- Scheduled appointments for customers in person or by telephone.
- Scheduled and confirmed appointments.
- Handled incoming calls and directed callers to appropriate department or employee.
ECM CARE COORDINATOR
MARTIN LUTHER KING JR COMMUNITY HOSPITAL
Los Angeles
07.2023 - 06.2024
- Assist patients through the healthcare system by operating as a patient advocate and health systems navigator.
- Coordinate continuity of patient care with external healthcare organizations and facilities.
- Coordinate continuity of patient care with patients and families/caregivers following hospital admission, discharge, and Emergency Department visits.
- Report care barriers and challenges to physician or designee.
- Conduct comprehensive, preventive screenings for patients and/or assists all support staff in daily patient interactions as needed.
- Promote clear communication amongst interdisciplinary care team members by ensuring awareness regarding patient care plans.
- Facilitate patient medication management based upon standing orders and protocols.
- Participate as a successful team associate supporting data collection, health outcomes reporting, clinical audits, and pragmatic evaluation.
- Participates in the evaluation of clinical care, utilization of resources, and development of new clinical tools, forms, and procedures.
TRANSITIONAL CARE NAVIGATOR ED
MARTIN LUTHER KING JR COMMUNITY HOSPITAL
Los Angeles
07.2022 - 06.2023
- Responsible for monitoring execution of transitional care services through ongoing quality assurance visits with referral sources and other applicable entities.
- Ensure patient who have high risk medical conditions receive the care they need immediately after discharge from hospital.
- Identify patients' insurance carrier/IPA submit referral form attached with necessary documentation.
- Follow up on authorizations with Medical Group/IPA provide authorization details to patient.
- Schedule appointment once approved with appropriate specialty.
- Ensure all discharge orders are completed.
- Create hospital follow up appointments for patients with their PCP.
- Provide mental health resources.
- Explain to patients their health benefits.
RECEPTIONIST/INSURANCE COORDINATOR
GARDENA DENTAL GROUP
Gardena
02.2018 - 03.2022
- Collect copayment and ensure fees are met before discharging patient.
- Documents all interventions in the patient medical record in a timely manner by including all elements of the needs requested by provider.
- Works collaboratively with team members; promotes collaborative relationships with team members and any vendors associated to facility.
- Update patient demographics and insurance registration.
- Manage flow and maintain waiting room area.
- Answer and triage calls, directing to appropriate individuals or departments.
- Perform check-in and check-out functions.
- Train new hire staff.
- Insurance verification, PPO/EPO, HMO, & MEDI-CAL.
- Schedule appointment once approved with the appropriate specialty.
- Ensure all discharge orders are completed, per multidisciplinary team.
- Conduct follow up calls to ensure patient are meeting expected goals as implemented by the provider.
- Run task list report and assign to team appropriately.
- Highlight overdue Health Maintenance.
- Available for comprehensive check-out with patients to address complex needs.
- Daily inventory, front desk and back office as needed.
PHARMACY CLERK
MEDICINE CABINET
05.2016 - 02.2018
- Verify prescription before filling medication.
- Confirm education level to determine understanding of medication.
- Verify high maintenance monthly medication refills to ensure patient are well equipped.
- Daily inventory, front desk and back office as needed.
- Verify insurance eligibility, MDCR part D, PPO, HMO, and Medi-Cal.
- Call patients to notify of medication pick up readiness.
Education
High school diploma -
GARDENA HIGH SCHOOL
Gardena06.2012
Skills
- Bilingual: Spanish and English
- Extensive computer knowledge of Microsoft Excel
- Extensive computer knowledge of Microsoft Word
- Typing 40 WPM
- Knowledge of Power Point
- Able to meet deadlines
- Fast learner
- Punctual
- Responsible
- Patient advocacy
- Customer service
- Electronic medical records
- Effective communication
References
- Victor Uribe, Supervisor, Martin Luther King Jr Community Healthcare, (323)806-1829
- Kristy Quiroz, Lead, Martin Luther King Jr Community Healthcare, (323)333-0957
- Angel Hernandez, Lead, Martin Luther King Jr Community Healthcare, (310)612-2430
Timeline
Appointment Coordinator
Gardena Dental Group
08.2024 - 03.2025
ECM CARE COORDINATOR
MARTIN LUTHER KING JR COMMUNITY HOSPITAL
07.2023 - 06.2024
TRANSITIONAL CARE NAVIGATOR ED
MARTIN LUTHER KING JR COMMUNITY HOSPITAL
07.2022 - 06.2023
RECEPTIONIST/INSURANCE COORDINATOR
GARDENA DENTAL GROUP
02.2018 - 03.2022
PHARMACY CLERK
MEDICINE CABINET
05.2016 - 02.2018
High school diploma -
GARDENA HIGH SCHOOL