Saile Vallejo
Weslaco
Summary
Healthcare professional with a robust background in patient care coordination and insurance verification. Skilled in managing patient inquiries and streamlining referral processes, ensuring compliance with regulations while enhancing service efficiency and satisfaction.
Overview
9
9
years of professional experience
Work History
Patient Care Coordinator
ALPINE PHYSICIANS
Edinburg
09.2025 - Current
- Coordinated communication between patients and healthcare providers for seamless care delivery.
- Facilitated referral processes by connecting patients with specialists, ensuring timely access to care.
- Educated patients on treatment plans and follow-up procedures to improve adherence.
- Communicated with patients to ensure quality of care and develop care plans.
- Assisted patients with insurance verification and eligibility inquiries for smooth processing.
- Processed patient intake information and updated medical records prior to treatment.
- Organized patient records using electronic health record systems for efficient access and retrieval.
- Scheduled appointments for patients and coordinated follow-up visits.
- Collaborated with medical staff to streamline administrative processes and improve workflow efficiency.
- Adapted to changes in patient care practices to ensure continuity of care. during changes to patient care practice.
- Provided ongoing communication with patients, families, and other healthcare providers regarding treatment plans and progress.
- Followed up with discharged patients to confirm adequate post-care support and address any concerns.
Referral Specialist
Kaizen Clinical Partners
Weslaco
12.2022 - 08.2025
- Processed incoming referral requests for medical services and submitted them to the appropriate insurance companies for authorization.
- Verified insurance eligibility for referred services using online databases and contacted insurers directly.
- Interpreted complex benefit plans accurately when determining whether requested services are covered under an individual's policy.
- Resolved escalated patient complaints relating to denied or delayed referrals promptly.
- Tracked referral progress from submission through authorization or denial notification to ensure timely updates.
- Reviewed all documentation associated with each referral request to ensure compliance with relevant regulations.
- Assisted patients in understanding their insurance coverage and answered questions about referrals, authorizations, and other related issues.
- Communicated regularly with referring physicians, nurses, case managers, social workers, and other healthcare professionals regarding referral processes and requirements.
- Identified potential problems with referrals before submitting them to insurers and worked with providers to resolve those issues quickly.
- Provided support to referring physicians in obtaining pre-authorization for services as necessary.
- Researched and responded to inquiries from providers regarding pending or denied referrals in a timely manner.
- Collected and analyzed referral data to provide insights on referral volume and patterns.
- Developed strategies for improving efficiency within the department while maintaining high standards of customer service.
- Facilitated communication between primary care physicians, specialists, and patients to ensure a smooth referral process.
- Monitored referral outcomes and reported trends to healthcare management teams to identify areas for improvement.
Receptionist
Kaizen Clinical Partners
Weslaco
05.2022 - 08.2025
- Answered incoming calls, took messages, and transferred calls to appropriate departments or personnel.
- Greeted visitors and assisted with inquiries, enhancing overall visitor experience.
- Provided excellent customer service at all times while interacting with both internal and external customers.
- Verified visitors' identification cards before allowing access to the building.
- Scheduled appointments for clients, customers, and other visitors.
- Provided administrative support to staff members by typing letters, filing documents, scanning, and copying, ensuring efficient office operations.
- Maintained organized filing system for confidential client information, ensuring compliance with company policy.
- Prepared welcome packages for new hires.
Medical Assistant
Dr. Gregoris Nuñez
Weslaco
04.2017 - 12.2017
- Administered injections, medications, and treatments according to physician instructions.
- Assisted physicians with patient care by taking vital signs, patient histories and preparing patients for examinations.
- Conducted patient interviews to gather medical history, chief complaints, and vital signs for comprehensive health assessments.
- Educated patients on nutrition and disease prevention to enhance understanding of health management.
- Provided assistance to medical staff in performing minor surgical procedures.
- Collected samples from patients for laboratory testing purposes.
- Prepared laboratory specimens for analysis and organized lab results for review by the physician.
- Performed basic laboratory tests such as urinalysis and blood glucose levels under direct supervision of a physician or registered nurse.
- Maintained accurate medical records through efficient filing, charting, transcription, and data entry into electronic health record system to support streamlined patient care.
- Ensured that all instruments used during exams were cleaned properly after each use according to established protocols.
- Recorded detailed notes during patient visits to track medical history and treatment progress. during patient visits.
- Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.
Education
High School Diploma -
Weslaco East High School
Weslaco, TX05-2016
Some College (No Degree) - Medical Assistant
South Texas Vo-Tech
Weslaco, TXSkills
- Referral management
- Insurance verification
- Benefit analysis
- Regulatory compliance
- Electronic health records
- Patient coordination
- Patient instruction
- Scheduling
- Medical record requests
- Patient record organization
- Care team collaboration
- Organizational skills
- Problem solving
Languages
- English
- Spanish
Timeline
Patient Care Coordinator
ALPINE PHYSICIANS
09.2025 - Current
Referral Specialist
Kaizen Clinical Partners
12.2022 - 08.2025
Receptionist
Kaizen Clinical Partners
05.2022 - 08.2025
Medical Assistant
Dr. Gregoris Nuñez
04.2017 - 12.2017
High School Diploma -
Weslaco East High School
Some College (No Degree) - Medical Assistant
South Texas Vo-Tech