RONY MEDINA
Summary
Physician Assistant/Workers Compensation Claims Assistant with proven expertise at Proactive Work Health Services in patient management and claims investigation. Recognized for enhancing claim processing efficiency and fostering strong relationships through exceptional communication. Adept at developing comprehensive care plans and maintaining meticulous documentation, ensuring optimal patient outcomes and compliance with regulations.
Overview
26
26
years of professional experience
Work History
Physician Assistant/Workers' Compensation Claims Assistant
Proactive Work Health Services
09.2014 - 02.2025
- Ensured compliance with state regulations and company policies through diligent review of all claim-related materials.
- Exhibited excellent problem-solving skills when encountering complex medical cases, collaborating with physicians and other healthcare professionals to determine the most appropriate course of action for optimal patient outcomes.
- Maintained strong relationships with policyholders, agents, and colleagues by consistently demonstrating professionalism, empathy, and effective communication skills.
- Assisted clients in understanding their insurance coverage by explaining complex terms and conditions clearly and concisely.
- Improved claim processing efficiency by conducting thorough investigations and promptly addressing discrepancies.
- Streamlined workflow for faster claim resolution by coordinating with various internal departments and external agencies.
- Reduced the number of fraudulent claims by implementing advanced investigative techniques and collaborating with law enforcement when necessary.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Maintained contact with claimants and attorneys to determine treatment status.
Physician Assistant
HealthFirst Medical Group
05.2004 - 07.2014
- Ordered and interpreted diagnostic testing to confirm diagnosis and implement accurate treatment plans.
- Conducted physical examinations to assess patients' health and current condition for optimal treatment.
- Exhibited excellent problem-solving skills when encountering complex medical cases, collaborating with physicians and other healthcare professionals to determine the most appropriate course of action for optimal patient outcomes.
- Streamlined clinic workflow by collaborating closely with physicians, nurses, and support staff.
- Facilitated multidisciplinary team meetings for comprehensive care planning and improved client satisfaction.
- Managed high caseloads effectively while maintaining close attention to detail and accuracy in documentation.
- Developed and implemented comprehensive case management plans to address client needs and goals.
Office Case Manager
Western and Venice Medical Group
09.1998 - 10.2003
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
- Achieved positive client outcomes by developing and implementing comprehensive case management plans.
- Advocated for client rights when interacting with external agencies or institutions, ensuring fair treatment at all times.
- Coordinated services with other agencies, community-based organizations, and healthcare professionals to provide useful benefits to clients.
- Collaborated with multidisciplinary teams to address client needs and formulate tailored support strategies.
- Fostered open lines of communication with clients'' families and support networks, involving them in the case management process as appropriate.
- Participated in regular professional development opportunities to stay current on best practices within the field of case management.
- Partnered with physicians, social workers, activity therapists, nutritionists, and case managers to develop and implement individualized care plans and documented patient interactions.
Education
Health Sciences
Charles R. Drew University of Medicine And Science
Los Angeles, CA08-1998
Physician Assistant Certificate - Medicine
Charles R Drew University of Medicine And Science
Los Angeles, CA08-1998
Skills
- Patient management
- Patient assessments
- Case management
- Claims processing
- Advanced oral and written communication skills
- Caseload management
- Decision-making
Languages
Spanish
Native or Bilingual
Timeline
Physician Assistant/Workers' Compensation Claims Assistant
Proactive Work Health Services
09.2014 - 02.2025
Physician Assistant
HealthFirst Medical Group
05.2004 - 07.2014
Office Case Manager
Western and Venice Medical Group
09.1998 - 10.2003
Health Sciences
Charles R. Drew University of Medicine And Science
Physician Assistant Certificate - Medicine
Charles R Drew University of Medicine And Science
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