Summary
Overview
Work History
Education
Skills
Languages
Timeline
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ROSA MARTINEZ-MIRELES

Los Angeles,CA

Summary

Bilingual Administrative Professional with 25+ Years of Experience. Accomplished administrative expert offering over two decades of success providing exceptional bilingual support to executives, leadership teams, and cross-functional groups. Adept at streamlining processes, implementing best practices, and maintaining confidentiality with proprietary information. Proven ability to increase productivity through efficient calendar management, meeting planning, document composition, and office organization. Recognized for professionalism, diplomacy, and tact when interacting with staff at all levels. Leverage outstanding communication abilities in both English and Spanish to facilitate seamless operations.

Overview

18
18
years of professional experience

Work History

Health Administration Service Medical Support – Contract Role

VA Greater Los Angeles Healthcare System (Citadel Federal Solutions, LLC)
04.2023 - Current
  • Excelled in patient intake, verifying demographics, insurance, and VA eligibility with 95% accuracy, while scheduling appointments adhering 90% to timelines
  • Responded promptly to inquiries maintaining 90%+ patient satisfaction, ensuring meticulous EHR documentation complying with VA regulations
  • Processed medical records requests within 24 hours at 100% HIPAA compliance and achieved 98% accuracy in insurance verification and coding
  • Managed medical inventory optimizing stock levels, while collaborating with providers on scheduling and care coordination
  • Contributed to a 10% departmental efficiency increase through team engagement and quality initiatives
  • Conducted audits at 99% accuracy, implementing solutions resulting in 15% improved efficiency and care quality
  • Assisted in emergency preparedness, responding effectively to medical crises after comprehensive training
  • Proactively screened for suicide risk, coordinating crisis response and follow-up care with healthcare teams.

Remote Customer Service Representative – Contract Role

Oregon Health Authority, (TotalMed)
11.2022 - 12.2022
  • Responded promptly to inbound phone inquiries, achieving a 98% call response rate within the first minute
  • Resolved customer complaints in a timely manner, ensuring a 95% customer satisfaction rate
  • Implemented robust record-keeping systems, reducing retrieval times by 40% and enhancing service efficiency
  • Fostered efficient knowledge-sharing practices within the team, leading to a 30% increase in issue resolution speed
  • Collaborated with cross-functional teams to optimize Total Time to Customer Satisfaction (TTCs), reducing it by 25%.

Remote Specialist Member Engagement – Contract Role

Molina Healthcare (The Wherry Group)
10.2022 - 11.2022
  • Demonstrated efficiency and effectiveness in addressing member inquiries, achieving a 95% first-call resolution rate
  • Maintained high service quality standards, resolving 90% of member issues within 24 hours
  • Conducted data analysis to drive informed decision-making, contributing to a 10% improvement in process efficiency
  • Delivered exceptional customer service, enhancing member experience and achieving a 92% member satisfaction rate.

Remote Benefits Coordinator – Contract Role

United Healthcare Group (Healthcare Support Staffing, Inc)
09.2022 - 09.2022
  • Managed and administered employee benefits programs, including health insurance and retirement plans, ensuring 100% compliance with company policies and regulations
  • Effectively communicated benefit plans and changes to employees, achieving a 98% satisfaction rate in understanding and clarity
  • Coordinated the annual benefits of open enrollment process with precision and accuracy, resulting in a 95% on-time completion rate.

Remote Benefits Coordinator – Contract Role

United Healthcare Group (Healthcare Support Staffing, Inc)
09.2022 - 09.2022
  • Managed and administered employee benefits programs, including health insurance and retirement plans, ensuring 100% compliance with company policies and regulations
  • Effectively communicated benefit plans and changes to employees, achieving a 98% satisfaction rate in understanding and clarity
  • Coordinated the annual benefits of open enrollment process with precision and accuracy, resulting in a 95% on-time completion rate.

Remote Bilingual Spanish Patient Advocate Representative

Accessone Medcard, Inc
04.2022 - 05.2022
  • Provided bilingual support to Spanish-speaking patients, enhancing communication and care accessibility, leading to a 20% increase in patient satisfaction
  • Assisted patients in navigating healthcare systems, ensuring understanding and efficient service, achieving a 95% resolution rate
  • Managed patient inquiries, resolved concerns with empathy and professionalism remotely, maintaining a 98% positive feedback rate
  • Facilitated access to financial assistance programs, improving patient care affordability, increasing program enrollment by 15%
  • Liaised between patients and healthcare providers, ensuring accurate information exchange, reducing communication errors by 25%.

Remote Clinical Admin Coordinator – Contract Role

United Healthcare Group (Healthcare Support Staffing, Inc.)
09.2021 - 11.2021
  • Assisted with administrative tasks to support clinical operations, ensuring 100% adherence to procedural protocols
  • Facilitated coordination of clinical activities, resulting in a 20% improvement in workflow efficiency
  • Collaborated effectively with team members, contributing to a 15% increase in operational efficiency
  • Participated in quality assurance processes to uphold service standards, achieving a 98% compliance rate with internal audits.

Case Care Management Assistant – Contract Role

Health Net Federal Services (Wollborg Michelson Personnel Service)
07.2021 - 07.2021
  • Managed healthcare services for military and veteran beneficiaries with care and attention, achieving a 98% beneficiary satisfaction rate
  • Conducted remote assessments to ensure accurate beneficiary support, maintaining a 95% accuracy rate in assessments
  • Updated beneficiary records accurately and efficiently, reducing record discrepancies by 20%
  • Provided essential administrative assistance to support case management, enhancing overall case processing speed by 15%.

Healthcare Patient Support Representative – Contract Role

OPTUM (Aspire Staffing)
06.2021 - 07.2021
  • Managed patient inquiries with empathy and professionalism, achieving a 95% patient satisfaction rate
  • Collaborated closely with healthcare providers to ensure seamless patient care, contributing to a 20% improvement in care coordination
  • Resolved patient issues promptly, enhancing patient satisfaction and reducing complaint resolution time by 25%
  • Maintained accurate patient records and assisted in scheduling appointments, achieving a 98% accuracy rate in documentation and scheduling.

Remote Intake Specialist/Member Level Processor Associate Medicare Installation and Billing - Contract Role

Blue Shield of Ca (Wollborg Michelson Personnel Service)
09.2020 - 04.2021
  • Processed Medicare enrollments accurately and efficiently, achieving a 98% accuracy rate
  • Handled billing inquiries with attention to detail, resolving 90% of issues within 24 hours
  • Managed member information entry, ensuring data accuracy and reducing errors by 15%
  • Communicated effectively with internal and external teams, contributing to a 20% increase in operational efficiency
  • Conducted quality checks to ensure data integrity, maintaining a 99% compliance rate.

Enrollment Health Advocate

Gracelight Community Health (formerly QueensCare Health Centers)
01.2020 - 06.2020
  • Managed application processing workflow to expedite enrollment procedures, reducing processing time by 30%
  • Collaborated effectively with insurance providers to ensure smooth enrollment processes, achieving a 95% enrollment success rate
  • Produced detailed reports to meet organizational requirements and drive decision-making, improving reporting accuracy by 20%
  • Delivered comprehensive program information to stakeholders, enhancing stakeholder understanding and engagement by 15%
  • Conducted thorough research to support program development, contributing to a 10% improvement in program effectiveness.

Family Service Enrollment Program Assistant II

Crystal Stairs, Inc
01.2006 - 01.2020
  • Provided administrative support with a focus on efficiency and accuracy, reducing processing time by 25%
  • Offered superior customer service, achieving a client satisfaction rating of 95%
  • Ensured accurate assessment of eligibility documentation for program enrollment, maintaining a 98% accuracy rate.

Education

Associate of Arts - Psychology/Sociology

Los Angeles City College
Los Angeles, CA
12.2022

Associate of Arts - Liberal Arts Social And Behavioral

Los Angeles City College
Los Angeles, CA
02.2022

Associate of Science - Business Administration And Management

Los Angeles City College
Los Angeles, CA
02.2022

Associate of Arts - Computerized Business Specialist

American Career College
Los Angeles, CA
06.2006

Skills

  • Healthcare Knowledge
  • Quality Assurance
  • Bilingual (English &Spanish)
  • Data Analysis
  • Staff Management
  • Human Resource Management
  • Project Management
  • Technical Proficiency
  • Patient Care
  • Financial Management
  • Conflict Resolution
  • Electronic Health Records (EHR) Management

Languages

Spanish
Full Professional
English
Professional Working

Timeline

Health Administration Service Medical Support – Contract Role

VA Greater Los Angeles Healthcare System (Citadel Federal Solutions, LLC)
04.2023 - Current

Remote Customer Service Representative – Contract Role

Oregon Health Authority, (TotalMed)
11.2022 - 12.2022

Remote Specialist Member Engagement – Contract Role

Molina Healthcare (The Wherry Group)
10.2022 - 11.2022

Remote Benefits Coordinator – Contract Role

United Healthcare Group (Healthcare Support Staffing, Inc)
09.2022 - 09.2022

Remote Benefits Coordinator – Contract Role

United Healthcare Group (Healthcare Support Staffing, Inc)
09.2022 - 09.2022

Remote Bilingual Spanish Patient Advocate Representative

Accessone Medcard, Inc
04.2022 - 05.2022

Remote Clinical Admin Coordinator – Contract Role

United Healthcare Group (Healthcare Support Staffing, Inc.)
09.2021 - 11.2021

Case Care Management Assistant – Contract Role

Health Net Federal Services (Wollborg Michelson Personnel Service)
07.2021 - 07.2021

Healthcare Patient Support Representative – Contract Role

OPTUM (Aspire Staffing)
06.2021 - 07.2021

Remote Intake Specialist/Member Level Processor Associate Medicare Installation and Billing - Contract Role

Blue Shield of Ca (Wollborg Michelson Personnel Service)
09.2020 - 04.2021

Enrollment Health Advocate

Gracelight Community Health (formerly QueensCare Health Centers)
01.2020 - 06.2020

Family Service Enrollment Program Assistant II

Crystal Stairs, Inc
01.2006 - 01.2020

Associate of Arts - Psychology/Sociology

Los Angeles City College

Associate of Arts - Liberal Arts Social And Behavioral

Los Angeles City College

Associate of Science - Business Administration And Management

Los Angeles City College

Associate of Arts - Computerized Business Specialist

American Career College
ROSA MARTINEZ-MIRELES