Nayely Saldana
Sacramento,CA
Summary
Looking for a long term employment with a stable reputable company where I can continue to utilize my skills, learn, provide support and make a sustainable contribution towards its growth.
Overview
10
10
years of professional experience
1
1
Certification
Work History
HR LOA Intake Specialist
CommonSpirit Health
06.2021 - Current
- Opens the claim; determines eligibility; sends all notifications; validates whether the request is a new claim or an extension of an existing claim; and uses all Case Management features and functionality including notes, new tasks, correction of a personal or employment information if necessary.
- Call Center Operations: Answers incoming calls to set up leaves of absence as part of the Intake team; provides exemplary service in both quality and quantity, to employees and others in the organization starting or inquiring about leaves of absence; and performs outbound call backs as required and on rotation.
- Follow up: reports and follows up on any Case Management issues or problems; and completes the follow up on initial STD intake requests
- CLMS , Certified
- Help Employee's in obtaining eligibility under FMLA, CFRA, Medical Leaves.
Patient Service Representative
Dignity Health
Folsom, CA
09.2020 - 06.2021
- Accessed patient information through variety of office software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
- Scheduled patient appointment and procedures with GECB and CERNER.
- Referred patients to appropriate professionals and services.
- Checked daily doctor schedules and verified insurance.
- Proficiency in using e-mail systems, Internet and MS office software applications
- Taking complete and accurate messages, and scheduling mutually acceptable appointment times utilizing an electronic appointment management system, electronic health record, and contact center system.
Patient Care Coordinator
Western Dental & Orthodontics
Roseville, CA
11.2015 - 03.2019
- Provide patient consultations and communicate information about recommend treatment plans.
- Discuss cost of service , insurance coverage and payment options
- Set and achieve personal sale goals while supporting team goals.
- Handling challenging patient and finding quick resolutions .
- Introduce new patients to office and staff .
- Support strategic local marketing initiatives that help drive brand awareness and new patient growth.
- Customer service acknowledgement; smile greet patients upon arrival and dismissal.-
- Handling multiple phone lines, and patients
- HIPPA knowledge
- Scheduling , Answering telephones, and and maintaining appointment book
Buyer
Ebara Technologies Inc.
Sacramento, CA
04.2017 - 10.2017
- Maintains files, logs and records of invoices.
- Handel work orders, and replace or repair order management
- Assist on expediting orders thru Japan and within the US
- Contacting Vendors to obtain prices and schedule deliveries
- Run MRP and analyze ,verify, recommended purchase and place purchase orders to vendors and suppliers.
- Recommended optimal suppliers after qualifying vendors and evaluating proposals.
- Analyzed sales trends to maximize sales potential.
- Complied with federal, state and company policies, procedures and regulations.
- Organized inventory for multiple locations.
- Communicated closely and effectively with all partners, including vendors, merchants and the distribution center, which helped to ensure well-timed product deliveries.
Patient Access Representative
Sutter Health
Roseville’s , CA
09.2019 - 09.2014
- Accessed patient information through variety of office software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
- Knowledge of insurances including HMO, PPO, Medicare, Medi-Cal, and other federal and state agency programs
- Provide patients with benefits breakdowns Using Ecare next system.
- Epic Software and Ecare
- Identifying limitations and exclusions
- Work in High call volumes and time limits
- Customer Service attention to detail and keyboarding skills
- Checked insurance benefits, received payments and provided receipts.
- Verified patient information, including demographics, insurance and providing patient estimates for outpatient/inpatient procedures
Education
Natomas High School
2011
American River College
Skills
- Patient Confidentiality
- Strong Communication
- Team player
- Self Motivated
- Multi-Task Management
- Creative Problem Solving
- High Call volume / Call Center
- Maintain Quality Standards
- Appointment Scheduling
- Ability To Effectively Communicate
- Insurance Knowledge
- Leave of absence , CLMS certified
- Insurance Authorization
- Patient Registration
- Policies implementation
- Conflict resolution
- Eligibility Review
Certification
- Leave Management ,CLMS DMEC
Timeline
HR LOA Intake Specialist
CommonSpirit Health
06.2021 - Current
Patient Service Representative
Dignity Health
09.2020 - 06.2021
Patient Access Representative
Sutter Health
09.2019 - 09.2014
Buyer
Ebara Technologies Inc.
04.2017 - 10.2017
Patient Care Coordinator
Western Dental & Orthodontics
11.2015 - 03.2019
Natomas High School
American River College