Nicole N. Reinoso Coronado

-Implement personalized and targeted interventions in Childhood Immunization Status (CIS) rates.
-Manage and analyze quality data from NextGen for 45+ primary care and specialty locations, ensuring compliance with National Committee for Quality Assurance (NCQA) standards and recognition.
-Present detailed root cause analysis to lead physicians and senior leadership, facilitating the identification and resolution of critical safety and quality concerns.
-Optimize workflows across 35+ clinics, resulting in improved patient satisfaction and operational efficiency.
-Analyze gaps-in-care reports to enhance patient safety and support financial incentive programs.

• Work with Quality Department on projects related to continuous quality improvement.
• Responsible for initiating formula and SYNAGIS prior authorizations claims.
• Responsible for initiating and follow-up on medication prior authorization claims.
• Accountable for the comprehensive management of pre-operative procedures and clearance forms, ensuring their timely receipt and transmission to the appropriate specialists.
• Develop office workflow suggestions that further the efforts towards team based care.
• Assist patients in issues with social service needs such as food stamps, Medicaid, and WIC.
• Use EHR to track all specialists referrals, lab tests and imaging orders.
• Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.

• Worked on a special project, driving innovation within the organization's programs and initiatives.
• The food & Dining Services Dept. was building a modernized ordering app where nurses and doctors can order food in advance by using their phones in the cafeteria. My role was to move data(prices) and compare all the item/food/beverage prices from the neighboring hospitals.

• Managed over 100+ patients per day.
• Worked with over 55+ referrals per month in different departments such as DI's imaging and stat's specialist.
• Experience on pre-authorization for medical procedures.
• Reviewed and corrected WC and MVA claim errors to facilitate smooth processing.
• Used medical terminology knowledge to explain procedures, policies and services to patients.
• Took copayments and compiled daily financial records.
• Responded to patient emergencies with immediate care and notified clinicians to provide comprehensive assistance.
• Obtained patient information to properly record and document demographics and medical histories.
• Answered patient assistance calls, assessed needs and offered qualified support.
• Assisted patients in understanding how insurance coverage works.

• Kept reception area clean and neat to give visitors positive first impression.
• Responded to inquiries from callers seeking information.
• Provided clerical support to company employees by copying, faxing and filing documents.
• Assured timely verification of insurance benefits prior to patient procedures or appointments.
• Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
• Input financial data and produced reports using WebPT.
• Responsible for scheduling more than 50+ physical therapy appointments per week