Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Nelly Castro

Cedar Hill,TX

Summary

Driven Patient Care Coordinator adept at planning care, coordinating interdisciplinary teams and making strategic improvements. Patient-focused and equipped with administrative and customer service expertise. Helps keep healthcare services proceeding smoothly by coordinating communications, referrals and policy enforcement. Talented in finding balanced solutions and resolving conflicts.

Overview

8
8
years of professional experience

Work History

Youth Leader

Jahweh Rafah Church
Balch Springs, TX
01.2024 - Current
  • Developed and implemented engaging activities for youth to build social, emotional, and physical skills.
  • Counseled youth on personal issues related to family dynamics, peer pressure, substance abuse prevention and mental health awareness.
  • Conducted regular meetings with staff members to discuss strategies for improving program effectiveness.
  • Managed budgeting processes related to program expenses such as supplies, transportation costs and facility rentals.
  • Mentored, instructed and supervised participating youths through collaborative efforts with like-minded, creative and inspirational team members.
  • Planned and led weekly Bible study meetings and facilitated group activities for teenagers.
  • Engaged older youth by following, implementing and assisting in creating lesson plans.

Care Advocate

Employer Direct Health Care
Dallas, TX
05.2022 - Current
  • Assisted patients in understanding individual rights and responsibilities in regards to care, coverage and payment.
  • Utilized knowledge of available resources to help patients obtain relevant support.
  • Documented activities and progress in electronic medical record per defined policy and procedures.
  • Helped patients obtain health care services by setting up referrals for 50-100 patients per month.
  • Facilitated communication between patients, medical and administrative staff, administrative staff and regulatory agencies.
  • Helped patients file appeals to insurance denials and worked with insurance companies to resolve disputes.
  • Entered details into computer systems and managed database of information.
  • Managed database of patient information and frequently used computerized systems to track details.
  • Worked with patients to appeal insurance decisions and coordinated with providers to resolve problems
  • Managed a large pre-surgical caseload of 80-100 patients in a fast paced environment.
  • Booked Travel for patients using company credit card
  • Fostered positive employee relationships through communication, and training.
  • Prioritized and organized tasks to efficiently accomplish service goals.
  • Assisted with manager level customer requests to improve satisfaction.
  • Collaborated with clinical and administrative staff to meet patient needs.
  • Received inquiries or complaints and directed to appropriate departments.
  • Reported liabilities and risk management concerns to supervisor for review.
  • Developed and completed new projects, reports, and procedures
  • Prepared presentations for team related meetings
  • Created and maintained required spreadsheets and reports for tracking mechanisms.
  • Collaborated with team leaders to complete insurance verification reports for billing purposes
  • Processed daily outreaches and documentation for member inquiries
  • Developed and coordinated training presentations to help individuals improve skills set
  • Assisted claimants, providers and clients with problems or questions regarding claims and directed to the corresponding department
  • Provided constructive feedback and positive reinforcement to keep trainees motivated.
  • Resolved customer complaints in a timely manner while ensuring customer satisfaction.
  • Provided guidance and direction to subordinates regarding job duties and responsibilities.
  • Monitored employee productivity to provide constructive feedback and coaching.
  • Reviewed completed work to verify consistency, quality and conformance.
  • Identified and corrected performance and personnel issues to reduce impact to business operations.
  • Tracked progress on projects and provided timely feedback to staff members.
  • Monitored employee productivity levels on a regular basis to identify areas of improvement.
  • Evaluated employee performance through periodic reviews and documented results accordingly.
  • Created new strategies for improving customer service standards within the organization.
  • Performed regular reviews of project documentation and communicated results with relevant personnel.
  • Developed and implemented project plans, established timelines, tracked progress and ensured deadlines were met.
  • Provided direction, guidance and support to team members throughout the duration of projects.
  • Assessed, monitored and reported on work progression.
  • Prioritized needs and delegated assignments to simultaneously handle multiple projects.

Lead Teacher

STEAMspark Montessori Experience
Farmers Branch, TX
10.2021 - 05.2022
  • Assisted fellow teachers with assignment development, special projects, tests, administrative updates and grading.
  • Coached new teachers on school guidelines to decrease training time and increase teacher success.
  • Communicated objectives for lessons, units and projects to students and parents.
  • Completed teacher observations to identify areas for improvement and suggest changes to teaching methods.
  • Engaged students and boosted understanding of material using focused instructional strategies and hands-on activities.
  • Mentored other educators by delivering insight, positive feedback and constructive criticism.
  • Purchased and took inventory of student materials needed for lessons

Customer Service Representative

A-MAX Auto Insurance Call Center
Dallas, TX
08.2019 - 10.2021
  • Maintained customer satisfaction with forward- thinking strategies focused on addressing customer needs and resolving concerns.
  • Developed new strategies and systems for customer retention team. Increased efficiency and performance by providing feedback and helping create an automated dialing system.
  • Explained benefits, features and recommendations to maximize client retention.
  • Relayed customer feedback to cross-functional teams to improve products and services.
  • Trained new hires on products and services, best practices and protocols to reduce process gaps.
  • Organized client contracts, records and reports to strengthen traceability.
  • Asses Inventory and purchase office items needed using company credit card
  • Assisted senior staff in preparing course methods, organizing seminars and promoting presentations for trainees.
  • Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
  • Demonstrated leadership by making improvements to work processes and helping to train others.
  • Delegated daily tasks to team members to optimize group productivity.
  • Reviewed completed work to verify consistency, quality and conformance.
  • Assigned projects and distributed tasks to team members as per area of expertise.
  • Fostered positive employee relationships through communication, training and development coaching.
  • Promoted to leadership position in recognition of strong work ethic and provided exceptional customer service.
  • Monitored daily workflow to ensure adherence to established policies and procedures.
  • Assisted with special projects as needed such as creating presentations.
  • Facilitated communication between cross-functional teams within the organization.
  • Offered training and support to keep team members motivated and working toward objectives.
  • Participated in regular meetings with senior leadership to provide updates on team progress.

Cashier

Little Caesars
Arlington, TX
01.2016 - 12.2016
  • Learned roles of other departments to provide coverage and keep store operational.
  • Helped with purchases and signed customers up for rewards program.
  • Discounted purchases by scanning and redeeming coupons.
  • Processed refunds for incorrect, damaged and broken merchandise.
  • Tracked and purchased company inventories
  • Operated cash register or POS system to receive payment by cash, check and credit card.

Education

BA - Psychology

University of North Texas

Skills

  • Creative Problem Solving
  • Training Development Aptitude
  • Clerical and Filing Support
  • Multi-Line Telephone Systems
  • Benefits Explanation
  • Conflict Resolution
  • Computer Proficiency
  • Supervision
  • Insurance understanding
  • Relationship building
  • Caseload management
  • Appointment Scheduling
  • Insurance verifying
  • Evaluating Quality of Care
  • Patient Needs Assessment and Referral
  • Gathering Information from Patients
  • Patient Confidentiality and Data Security
  • Database Search and Data Entry Skills
  • Legal Compliance
  • Database Coordination
  • Insurance Authorizations
  • Bilingual Spanish and English
  • Attention to Detail
  • Administrative and Office Support
  • Ordering and Purchasing
  • Excel Spreadsheets
  • Customer Service
  • Critical Thinking
  • Recordkeeping and Documentation
  • Leadership Development
  • Employee Training
  • Adaptability and Flexibility
  • Team Collaboration
  • Microsoft Office

Accomplishments

  • Used Microsoft Excel to develop customer retention tracking spreadsheets during pandemic to help with transitioning to work from home.
  • Achieved Retention team organization by completing reports with accuracy and efficiency.
  • Supervised and Collaborated with Management in the development of Automated soft phone project by providing essential feedback, knowledge and testing.
  • Employee of the Month I was chosen Employee of the Month in recognition for effort and dedication to the Retention and Service Team.

Timeline

Youth Leader

Jahweh Rafah Church
01.2024 - Current

Care Advocate

Employer Direct Health Care
05.2022 - Current

Lead Teacher

STEAMspark Montessori Experience
10.2021 - 05.2022

Customer Service Representative

A-MAX Auto Insurance Call Center
08.2019 - 10.2021

Cashier

Little Caesars
01.2016 - 12.2016

BA - Psychology

University of North Texas

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Nelly Castro