Sandra Elias
San Leandro ,CA
Summary
Professional with 19 years of diverse experience in the customer service/healthcare industry seeking a challenging career in the the healthcare industry where experience and knowledge will contribute to the overall success and growth in the company. Seasoned Health Plan Representative provides clients with comprehensive coverage guidance. Tactful communicator translates complex coverage policies into comprehendible terms.
Overview
20
20
years of professional experience
Work History
Health Plan Repersenative
Kaiser Permanente
06.2019 - Current
- Communicate continually with a diverse set of internal and external clientele to achieve excellent results in the area of complaint and grievance handling, compliance, documentation, benefit/contractual information, and enhancement of member experience
- Developed strong relationships with healthcare providers by offering consistent support and assistance with health plan-related issues.
- Educated members on available benefits and resources, empowering them to make informed health decisions.
- Research and resolve, to the extent possible, member/system conflicts to obtain member satisfaction and minimize health plans risks.
Release of Medical Information
Kaiser Permanente
09.2017 - 06.2018
- Transcribed and entered patient medical information into electronic medical records systems.
- Researched and resolved medical record discrepancies.
- Followed up with medical staff regarding missing information in patient records.
- Processed and tracked requests for medical records from external organizations.
- Maintained accuracy, completeness, and security for medical records and health information.
- Protect patients rights to privacy by ensuring that only authorized individuals have access to the patient's medical information.
- Confirm that all requests are in compliance with company policy, State and Federal laws, and HIPAA regulations.
Education
Associate of Science - Health Administration
Colorado Technical University
Colorado Springs, CO04.2023
Skills
- HIPAA Compliance
- Insurance Eligibility
- Administrative Functions
- Microsoft Office
- Policy Knowledge
- Customer Complaint Resolution
- Health insurance
- Excellent Communication
- Organizational Skills
- Attention to Detail
- Problem-solving abilities
Languages
Spanish
Native or Bilingual
Timeline
Health Plan Repersenative
Kaiser Permanente
06.2019 - Current
Release of Medical Information
Kaiser Permanente
09.2017 - 06.2018
Associate of Science - Health Administration
Colorado Technical University
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