Rubiela Vazquez
Murrieta,CA
Summary
Possesses versatile skills in project management, problem-solving, and collaboration. Brings fresh perspective and strong commitment to quality and success. Recognized for adaptability and proactive approach in delivering effective solutions.
Overview
2026
2026
years of professional experience
Work History
Broker Coordinator
Molina Healthcare
2024 - Current
- Managed inbound calls, addressing inquiries from national brokers on application submittals and contracting questions.
- Educated brokers on plan benefits across all markets, enhancing understanding and engagement.
- Provided assistance with monthly reports for contracting team, ensuring accurate data tracking.
- Supported brokers in updating portals and resolving technical issues related to member access.
- Maintained department email inbox, ensuring prompt responses to broker communications.
- Monitored evolve queue regularly, guaranteeing timely updates and efficient workflow.
- Fostered strong relationships with brokers through effective communication and problem-solving. Streamlined processes to improve response times and overall service quality.
Care Review Processor
Molina Healthcare
01.2014 - 01.2024
- Collaborated with providers and departments to coordinate integrated care delivery for members.
- Facilitated assessments to ensure comprehensive support across services.
- Performed data entry and clerical tasks for Care Review team operations.
- Executed computer entries for authorization requests and provider inquiries efficiently.
- Verified eligibility and benefits while determining coordination of benefits status.
- Maintained accurate records of provider contracting status and treatment requests. Streamlined communication processes between teams to enhance operational efficiency.
Member Services II
Molina Healthcare
01.2013 - 01.2014
- Assisted providers with claim issues across multiple states, including reviews and status checks.
- Educated providers on denials and clarified questions regarding claims.
- Requested check tracers and verified provider contracts with state fee schedules.
- Provided updates and clarification on provider appeals to ensure understanding. Resolved complex member billing issues to enhance customer satisfaction.
- Contributed to meeting service levels and achieving customer service goals.
- Supported staff members in daily operations to maintain efficiency.
Member Services
Molina Healthcare
01.2010 - 01.2012
- Facilitated assistance for members and providers regarding health care coverage issues.
- Resolved issues related to primary care physician changes, medication processing, and authorization referrals.
- Updated demographic information and enrollment segments for accurate member records.
- Verified eligibility to ensure compliance with health care regulations.
- Achieved performance goals aligned with call center objectives consistently.
- Conducted on-the-job training for new hires during live calls to enhance team performance.
- Addressed escalated issues as assigned by management to maintain service quality.
Education
Medical Insurance Coding And Billing -
Charter College
Long Beach, CASkills
Customer interaction
Language fluency
Solution-oriented mindset
Time efficiency
People skills
Team collaboration
Analytical thinking
Extensive research capabilities
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Care Review Processor
Molina Healthcare
01.2014 - 01.2024
Member Services II
Molina Healthcare
01.2013 - 01.2014
Member Services
Molina Healthcare
01.2010 - 01.2012
Broker Coordinator
Molina Healthcare
2024 - Current
Medical Insurance Coding And Billing -
Charter College