Summary
Overview
Work History
Education
Skills
Timeline
Generic

Paula Mua

Sacramento,CA

Summary

Dedicated healthcare coordinator professional well-versed in communication and team building. Knowledgeable in medical terminology and scheduling. Ready to bring 10 years of relevant work experience to your team.

Offering strong interpersonal skills and genuine desire to learn and grow in healthcare setting. Brings solid foundation in customer service and administrative tasks, easily adaptable to healthcare environment's needs. Ready to use and develop communication and organizational skills in healthcare role.

Developed strong communication and problem-solving abilities in patient-centered environment, looking to transition into new field. Excelled in managing patient interactions and maintaining accurate records, ensuring smooth operations. Eager to apply transferrable skills in new and challenging role.

Professional with significant experience in patient services, ready to enhance patient experience. Skilled in managing patient interactions, scheduling, and administrative tasks. Strong focus on teamwork and adaptability ensures consistent and reliable support. Known for excellent communication skills, empathy, and problem-solving abilities.

Dependable coordinator serving diverse needs of patients through active communication and responsive engagement with healthcare services and policymakers. Skilled at analyzing case files and databases to speed up inquiry response times and guide information through appropriate personnel channels. Maintains highest standards of ethics, professionalism and regulatory compliance to ease common stressors and de-escalate potential conflicts.

Experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, ensuring high standards, and aligning efforts with organizational goals. Known for collaborative approach and commitment to excellence.

Overview

13
13
years of professional experience

Work History

Patient Services Rep III – Referral Auth Coordinator

UC Davis Health
12.2021 - Current
  • Ability to accomplish a variety of concurrent assignments in an effective and efficient manner, demonstrating ability to organize, prioritize and complete assignments in a designated time frame
  • Ability to adjust to changing workload or assignments and pressures of increased workload or deadlines
  • Knowledge of health care insurance systems, which may include Medi-Cal, Medicare, HMO, PPO, fee-for-service, county funded coverage, and workers’ compensation, sufficient to properly obtain and track authorizations, appoint patients, make referrals for consults, diagnostics and ancillary services, coordinate hospital services, complete and submit billing documentation, and explain provisions and requirements to patients
  • Decision making skills to independently exercise delegated authority to act and to appropriately seek assistance from others when limits of delegated authority have been reached
  • Interpersonal skills to establish and maintain effective working relationships with all co-workers; to consistently interact with patients and other members of the public with patience, courtesy and professionalism, both in person and on the telephone; and to effectively respond to individuals who may be angry or upset
  • Ability to efficiently use computer system applications for all functions required for this position, including electronic mail, spreadsheets, word processing, and medical office management, (i.e
  • Scheduling, template maintenance, maintenance of demographic and insurance information)
  • Detailed knowledge of coverage benefits, authorization and utilization review requirements for each payer type including third party liability, Federal Government payers (such as VA & Mcare), State (such as Medicaid & CCS), Private and Commercial payers, HMO/PPO & EPO plans
  • Ability to determine appropriate eligibility verification processes associated with the payer type(s)
  • Writing skills, using proper English grammar, spelling, and punctuation, sufficient to compose messages and/or routine correspondence, which is clear, concise and easy to understand

Contracts Coordinator

CENTENE Corporation -CALIFORNIA HEALTH AND WELLNESS
07.2017 - 03.2021
  • Proficient with PC and software applications including MS Outlook, MS Word/Excel/PowerPoint
  • Review and Analyze Physician information for Updating Physician Information into centralized database
  • Skills to research, collect, analyze, and interpret data from various sources
  • Interface with credentialing staff to ensure data and systems are in sync in system
  • Create contracts and manage the contracting process
  • Review and analyze to make recommendations for new business opportunities, prepare contract status and metric reporting, identify gaps and risks in contracting process
  • Assist with workload assignment for temporary contract coordination staff
  • Review and Analyze Maintain and Make Recommendations to collect, track, prepare, compile, and distribute statistical data for daily reports
  • Provide support to contract negotiators to ensure successful completion of contracting process
  • Review and analyze to be able to identify gaps and risk in contracting process and coordinate with multiple departments to ensure contracting process is completed timely and accurately and within required established standards and guidelines
  • Maintain physical and electronic file systems
  • Provide support to other departments to ensure compliance with corporate contracting standards
  • Ability to accomplish a variety of concurrent assignments in an effective and efficient manner, demonstrating ability to organize, prioritize and complete assignments in a designated time frame
  • Ability to adjust to changing workload or assignments and pressures of increased workload or deadlines
  • Problem solving skills to independently define a problem identify the resources available to help solve the problem, create viable solutions and take the necessary action to implement problem resolution and ensure prompt and satisfactory resolution

Registry/Office Assistant

Pacific Staffing Employment Services
07.2012 - 02.2014
  • Company Overview: (Mercy Family Health Center)
  • Registration and scheduling and answering phone lines (over 35 lines per day)
  • Ability to interpret standards, assess situation and determine appropriate course of action
  • Provide new and existing patients with a high degree of care and patient services
  • Medical records (HIM) internal and external processing, data entry, filing, and scanning
  • Experience with filing skills to maintain logs and files of information in alphabetical, chronological and/or numerical order, such that it is current and easily retrievable
  • Knowledge of all pertinent laws utilizing ROI (Release of Information) forms, regulations, and guidelines governing medical records; confidentiality, privacy, and provision to others, including HIPAA
  • (Mercy Family Health Center)

Education

Bachelor of Science - Health care Administration – Concentration in Health Information Management

University of Phoenix
Sacramento, CA
07.2015

Microcomputers in Business Certificate & Medical Assistant Program Completion -

Merced College Career Advancement Academy Business Resources Center
Merced, CA
11.2009

High School Diploma -

Merced High School
Merced, CA
05.2004

Skills

  • Insurance verification
  • Patient registration
  • Appointment scheduling
  • Patient confidentiality
  • HIPAA compliance
  • Healthcare

Timeline

Patient Services Rep III – Referral Auth Coordinator

UC Davis Health
12.2021 - Current

Contracts Coordinator

CENTENE Corporation -CALIFORNIA HEALTH AND WELLNESS
07.2017 - 03.2021

Registry/Office Assistant

Pacific Staffing Employment Services
07.2012 - 02.2014

Microcomputers in Business Certificate & Medical Assistant Program Completion -

Merced College Career Advancement Academy Business Resources Center

High School Diploma -

Merced High School

Bachelor of Science - Health care Administration – Concentration in Health Information Management

University of Phoenix
Paula Mua