Sandra Navarro
Long Beach,CA
Summary
Dynamic financial professional with extensive expertise in transplant financial counseling, skilled in navigating complex systems such as Medicare, Medi-Cal, COBRA, Covered California, Social Security, Supplemental Security Income, and disability qualifiers. Proven track record in managing clinics independently and overseeing financial reporting, appointment scheduling, clearances, and registrations to optimize operational efficiency. Recognized for streamlining processes that enhance clinic productivity and reduce cancellations while maintaining a strong focus on quality patient care. Committed to fostering collaborative relationships across departments including admissions, billing, radiology, pharmacies, and labs, demonstrating adaptability and reliability in fast-paced environments.
Overview
34
34
years of professional experience
Work History
Transplant Financial Coordinator
Keck Medical Center of USC
Los Angeles, CA
05.2025 - Current
- Daily reporting processes to ensure accuracy, compliance and timely responses to actions entered by nursing staff for patient care.
- Communications and meeting with nurses, physicians and management regarding patients care and ability to be seen or unexpected delays of care.
- Maintained financial clearances for post-transplant patients care, monthly insurance verifications, obtaining authorizations, enhance decision-making regarding contacted plans and patients capabilities to be seen at Keck.
- Streamlined processing workflows, improving turnaround times for clinic patient authorizations and appointments.
Patient Care Coordinator
Retina Consultants of Orange County
01.2020 - 11.2024
- Provided excellent customer service.
- Responsible for answering patient questions and responding to or resolving patient concerns or frustration.
- Patients are the priority.
- Customer service is everything.
- Knowledgeable of all insurance types: HMO, PPO, POS, Medicare, Medicare Advantage, Medi-Cal, and Work Comp.
- Effectively and efficiently able to work in multiple software programs and applications, including EPIC and Nextech.
- Complied with OSHA and HIPAA regulations.
- Assisted in high call volume and managed multi-line VoIP system.
- Triaged patient phone calls.
- Sent tasks to the doctor teams.
- Took care of same-day add-ons from doctor-to-doctor calls.
- Opened and closed clinics, traveled to multiple clinics in one day, coordinated patient scheduling, check-in, check-out, and collected patient copay, injectable drug, and/or balance owed at the time of check-out.
- Verified charts for accuracy for next-day appointments, such as checking eligibility and authorization.
- Assisted patients with high-cost drug copays.
- Helped them enroll in and get approved for copay assistance programs through copay card programs for commercial plans, CDF for seniors, managed care, or free drug programs for cash patients, and helped seek claim reimbursement if needed.
- Maintained current and accurate medical records for patients by scanning new medical insurance, updated demographics, and any outside records or medication lists for doctor review.
- Scheduled appointments for doctors based on optimal patient loads and availability.
- Communicated effectively with doctors in the office or via text and email.
- Developed close working relationships.
- Responsible for maintaining relationships within our practice and with referring physicians.
- Maintained a professional, organized, and safe environment for patients and staff.
- Maintained the patient waiting room and ensured patient education and doctor bio cards were visible at the front desk for patients to read while waiting.
- Integrated and developed a full EHR-PM system with Nextech’s Practice Plus PM system and IntelleChart Pro, which helped our office succeed in meeting CMS guidelines in 2022.
Medical Front Office Lead
United Healthcare Group, Optum
01.2006 - 01.2020
- This was a busy family practice and provided walk-in urgent care needs on the other side of the practice, formerly known as Seal Beach Family Med Group. Opened 7 days a week and most holidays.
- Front Office Lead
- Led a team of 10 front office staff and worked alongside 12 providers, nurse practitioners, and physician assistants.
- Followed opening and closing procedures according to office policies.
- Greeted and checked in patients, as well as assisted them with intake forms.
- Ensured staff followed the standard workflow, company policies, and procedures.
- Facilitated meetings with the front office staff as needed.
- Proficient in greeting patients and providing instructions upon arrival.
- Checked patient insurance, demographics, and health history to keep information current.
- Maintained patient privacy following HIPAA policies.
- Coordinated patient scheduling, check-in, check-out, and collected payments for billing.
- Assisted patients with insurance, medical group, and plan benefit information, and helped them understand their EOBs.
- Optimized organizational systems for payment collections, A/P–A/R, deposits, recordkeeping, and claim follow-up.
- Processed medical claims in a timely manner.
- Posted and adjusted payments from insurance companies and sent out monthly patient statements.
- Effectively and efficiently able to work in multiple software programs/applications.
Claims Processor
Harriman Jones Medical Group, Optum
01.1992 - 01.2004
- Processed medical claim in a timely manner.
- Assisted patient with concerns over the phone.
- Completed date entry for the entire office
Education
No Degree - General Studies
Long Beach Polytechnic High School
No Degree - Medical Technology
Long Beach City College
Long Beach, CA09-1992
Skills
- Claim Processing
- Spanish Speaking
- EPIC, Cerner and OTTR systems
- HIPAA Compliance
- Occupational Safety and Health
- Time management
- Patient registration
- Patient financial Counseling
- Scheduling appointments; Customer Service
- Team Leadership, Problem Solving, Decision-making and Training
- Patient confidential Insurance coverage verification, use of insurance portals, Experian (Passport); Insurance Portals, Avality; Carelon and more
Timeline
Transplant Financial Coordinator
Keck Medical Center of USC
05.2025 - Current
Patient Care Coordinator
Retina Consultants of Orange County
01.2020 - 11.2024
Medical Front Office Lead
United Healthcare Group, Optum
01.2006 - 01.2020
Claims Processor
Harriman Jones Medical Group, Optum
01.1992 - 01.2004
No Degree - General Studies
Long Beach Polytechnic High School
No Degree - Medical Technology
Long Beach City College