Patricia Pinedo
Moreno Valley,CA
Summary
Supportive Eligibility Specialist with extensive application engagement and dedicated service skills. Bilingual professional with skill to maintain accurate records, schedule appointments and handle various administrative responsibilities. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
23
23
years of professional experience
Work History
Eligibility Specialist
Pristine Medical Billing
02.2019 - Current
- Maintained detailed records of client interactions, ensuring accuracy and confidentiality of sensitive information.
- Trained staff on current eligibility requirements and policies.
- Provided exceptional customer service through prompt response times, clear communication channels, and diligent follow-up practices.
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
- Used data entry skills to accurately document and input statements.
- Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
- Provided excellent customer service, developing and maintaining client relationships.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Monitored customer accounts to identify and rectify billing issues.
- Optimized workflow processes for increased productivity within the Billing Department, enabling staff members to focus on more strategic tasks.
- Self-motivated, with a strong sense of personal responsibility.
- Proven ability to learn quickly and adapt to new situations.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Paid attention to detail while completing assignments.
- Worked well in a team setting, providing support and guidance.
- Responsible for answering incoming calls for the Access Center in order to provide a variety of services through utilizing state-of-the-art telecommunications and computer information systems. Coordinates the scheduling, pre-registration and insurance eligibility for both hospital and physician practice services.
Underwriter
Mercury Insurance Co
08.2001 - 02.2019
- Provided excellent customer service by addressing inquiries promptly and offering comprehensive explanations of underwriting decisions.
- Built strong relationships with lenders, brokers and clients for constructive communications.
- Met with customers, agents and brokers to negotiate coverage, price, and service delivery.
- Improved risk assessment accuracy by conducting thorough reviews of loan applications and financial documents.
- Developed and implemented underwriting policies and procedures, establishing useful and accurate processing of applications.
- Excellent communication skills, both verbal and written.
- Applied effective time management techniques to meet tight deadlines.
- Organized and detail-oriented with a strong work ethic.
- Worked effectively in fast-paced environments.
- Paid attention to detail while completing assignments.
- Proven ability to learn quickly and adapt to new situations.
- Self-motivated, with a strong sense of personal responsibility.
Education
High School Diploma -
Garey High School
Pomona, CAMedical Insurance Billing
Uei College- Riverside
Riverside, CA10.2019
Skills
- Policy Interpretation
- Documentation and paperwork
- Appointment Scheduling
- Microsoft Office
- Telephone Etiquette
- Medicaid knowledge
- Effective communication skills
- Referral Coordination
- Data Entry
- Schedule Management
- Verbal Communication
- Clerical Support
- Multitasking
- Remote Office Availability
- Fluent in English and Spanish
- Attention to Detail
- Excellent Communication
- Organization and Time Management
- Call center experience
- Medical terminology knowledge
- Microsoft Excel
- CRM Software
- Microsoft PowerPoint
- Customer Service
- Understanding Customer Needs
- Spreadsheets
- Microsoft Outlook
- Quality Control
- Multi-line phone talent
- Computer Skills
Timeline
Eligibility Specialist
Pristine Medical Billing
02.2019 - Current
Underwriter
Mercury Insurance Co
08.2001 - 02.2019
High School Diploma -
Garey High School
Medical Insurance Billing
Uei College- Riverside
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