Raquel Ortega
Beloit,WI
Summary
To obtain a position that will enable me to use my strong organizational skills, education background and my ability to work well with others and to continue use of my courses related to this occupation.
Professional benefits administrator skilled in optimizing employee benefits programs and ensuring compliance. Known for effective communication and problem-solving skills, fostering collaborative team environment. Highly adaptable, with strong focus on achieving positive outcomes and meeting changing organizational needs.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Referral /Benefits Coordinator
Option Care Home Infusion
10.2017 - Current
- Processed orders from referral sources, responded to phone and fax inquiries, and resolving patient complaints
- Assess patient needs and document referral requests for coordination of care
- Coordinate with the Insurance Verification team to process patient details and collect benefit coverage information to bring patient on to our company for service
- Relaying insurance coverage to referral sources and patients and discuss forms required for billing with patients
- Worked with branch Admissions team to gather documentation for new patient processing
- Verify information on incoming documents for accuracy and completeness
- Contact insurance providers to verify benefit coverage
- Request authorization for payment from insurance provider
- Submit changes to patient prescriptions in the system and obtain authorization for payment
- Helped with Clerk process for our new intake team for the NPRCC at Option Care
- Also learned the duties of a clerk
- Scanning, Excel Spreadsheet/e-fax
- Submit payments on patients behalf in Change Healthcare Portal
- Additionally trained on COH, as well as sufficient in referrals for the Chronic therapies
Unit Secretary, Telemetry Technician
St Mary's Janesville Hospital
10.2011 - 02.2017
- Greet patients and family
- Admit Patients
- Administer and maintain patient records
- Telemetry Tech: Record, analyze and then report on a patient's heart rhythms
- Coordinate and assist with patient billing and charging for 3rd, 4th, and ICU departments
Unit Clerk, Certified Nursing Assistant
Mercy Hospital and Health system
09.2009 - 04.2011
- Provided assistance to patients with daily living activities
- Assisted Nurses and Doctors with patients' needs
- Continually filled out state required documentation
- Greeted patients and family members
- Transcribed doctors' orders into the computer
Certified Nursing Assistant
Cedar Crest Inc.
02.2008 - 06.2009
- Provided quality care to residents
- Organized and participate in Group activities
- Assisted with doctor appointments
- General Housekeeping
- Administration and Management of Medications
- Continually filled out state required documentation (MARS, Accidental Reports)
Certified Nursing Assistant
Wesley Willows Health Center, Inc.
11.2001 - 01.2008
- Provided quality care to clients
- Continually filled out state required documentation
- Give daily cares to residents
Education
Certificate - Nursing Assistant
Blackhawk Technical College
Janesville, WI08.2005
Current Part time Nursing student - Nursing Fundamentals and Pharmacology
Madison Area Technical College
03.2025
Associates Degree - Nursing, Prerequisites and generals
Rock Valley College
Rockford, IL08.2003
Skills
- Ability to effectively lead, motivate and teach others
- Highly organized
- Excellent time management skills
- Team player
- Exceptional written and communication skills
- Proficient in MS Word
- Proficient in Excel
- Proficient in PowerPoint
- Proficient in the Internet
- Accounting skills
- Ability to work in multiple areas related to the health field in a hospital or nursing home setting
- Benefits explanation
- Benefits administration
- Proficient in [software]
- Employee relations
- New employee enrollment
- Written and oral communication
- Relationship building
- Verbal and written communication
Certification
- Certificate in Dietary Needs, Menu planning, Food Preparation and Sanitation, obtained from Blackhawk Technical College
- Certificate in Standard Precautions, obtained from Blackhawk Technical College
- Certificate in Administration and Management of Medications, obtained from Blackhawk Technical College
- Extensive training and Certifications in Dementia and Medicare, obtained from previous employers
- CPR Healthcare provider certified
- Currently working PRN with Fortrea Clinical research unit as a Telemetry technician (10 plus experience as a telemetry technician).
Timeline
Referral /Benefits Coordinator
Option Care Home Infusion
10.2017 - Current
Unit Secretary, Telemetry Technician
St Mary's Janesville Hospital
10.2011 - 02.2017
Unit Clerk, Certified Nursing Assistant
Mercy Hospital and Health system
09.2009 - 04.2011
Certified Nursing Assistant
Cedar Crest Inc.
02.2008 - 06.2009
Certified Nursing Assistant
Wesley Willows Health Center, Inc.
11.2001 - 01.2008
Current Part time Nursing student - Nursing Fundamentals and Pharmacology
Madison Area Technical College
Associates Degree - Nursing, Prerequisites and generals
Rock Valley College
Certificate - Nursing Assistant
Blackhawk Technical College
Similar Profiles
Jada CortezJada Cortez
Prior Authorization Specialist at Option Care Home InfusionPrior Authorization Specialist at Option Care Home Infusion
Barbara ZimmermanBarbara Zimmerman
Infusion Nurse at Option Care Home InfusionInfusion Nurse at Option Care Home Infusion
Laurie RoseLaurie Rose
Quality Assurance Coordinator at Option Care Home InfusionQuality Assurance Coordinator at Option Care Home Infusion
KADIJAH ROSEKADIJAH ROSE
Certified Pharmacy Technician at Option Care Home InfusionCertified Pharmacy Technician at Option Care Home Infusion
Andrea RookAndrea Rook
Expert Lead Sales Associate at Mounds Pet Food WarehouseExpert Lead Sales Associate at Mounds Pet Food Warehouse