Sarita Zabala
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
10
10
years of professional experience
Work History
Customer Care Concierge Support
Blue Shield Of CA
11.2018 - 08.2021
- Maintained daily operations and functions to maximize the best care resolution to customer satisfaction and handled all patients with empathy and care while maintaining HIPAA guidelines at all times.
- Processed enrollments, claims, refunds, and all request regarding policy information for patients and members. Handled each case with critical thinking and problem-solving efforts to create standard procedures and minimize escalation. Created Provider relations with all providers.
- Conducted training and mentored team members to promote productivity, accuracy and commitment to friendly service.
- Built client relationships by responding to inquiries, identifying and assessing clients', providers,pharmacies, and members needs, resolving problems, and following up with potential and existing Members.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Determined patient financial needs and referred eligible patients to proper county, state or federal agencies to obtain financial assistance.
- Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
Eligibility Specialist II
Western Health Advantage
10.2017 - 06.2018
- Maintained confidential patient, employee and company information in compliance with company policies and regulatory requirements.
- Gathered information, assessed and fulfilled callers' needs and educated on important policies and procedures.
- Investigated and resolved customer inquiries and complaints quickly.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Explained estimated cost for medical treatments and answered patient questions to promote good understanding of proposed services.
- Attended weekly facility meetings to discuss logistical issues and obtain updated procedural and insurance-related instructions.
Claims Associate
Aerotek Staffing (River City Medical Group)
07.2017 - 10.2017
- Investigated [Type] damages, gathering information from diverse sources and delivering comprehensive reports.
- Examined reports, accounts and evidence to determine integrity and accuracy of information.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Verified client information by analyzing existing evidence on file.
- Generated, posted and attached information to claim files.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Patient Care Technician
Davita
05.2016 - 11.2016
- Obtained patient vital signs and reported results to staff nurse or physician, noting changes from prior measurements.
- Collected and transported specimens to prepare for lab testing.
- Supported patient admissions, discharges and transfers to promote team productivity.
- Responded to patient emergencies with immediate care and notified clinicians to provide comprehensive assistance.
- Evaluated patients to identify and address wounds, behavioral concerns and medically relevant symptoms.
- Warmly greeted patients and visitors and made each feel welcome.
- Cleaned, sanitized and moved hospital equipment.
- Responded to emergency situations to help with lifting and transporting patients.
- Cleaned and connected fistulas, grafts, and catheters to prevent infection.
- Monitored each patient closely during treatment to check for any adverse reactions or change in condition and reported emergencies to attending nurses.
- Recorded patient's pre-dialysis weight, vitals and any new medical conditions.
- Conducted equipment and safety checks on hemodialysis equipment and supplies.
- Set up and operated dialysis machines for patients receiving treatment for kidney failure.
- Safely transported, transferred, and positioned patients on chairs for treatment.
- Recorded client data on hemodialysis flow chart.
- Provided in-patient care for 4 dialysis patients simultaneously focusing on providing clean, safe and comfortable treatment environment.
- Inventoried, ordered, and restocked equipment and supplies needed for hemodialysis treatment.
- Administered Heparin, oxygen, anesthetic, and saline as prescribed.
- Updated patients' charts in electronic medical records with encounter information, prescriber notes and orders.
- Completed thorough assessments to understand current patient conditions and develop diagnoses.
Quality Assurance Auditor
Wolberg Michelson/ Blue Shield Of California
08.2014 - 01.2016
- Reviewed work instructions and production strategies to verify compliance with established standards.
- Completed timely quality reports highlighting deficiencies and recommending corrective actions.
- Educated and oriented employees to improve compliance with quality control protocols.
- Audited activities of workers production
- Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
Medical Assistant
DR IRA JOHNER
04.2010 - 08.2014
- Obtained client medical history, medication information, symptoms and allergies.
- Directed patients to exam rooms, fielded questions and prepared for physician examinations.
- Collected and documented patient medical information such as blood pressure and weight.
- Sanitized, restocked and organized exam rooms and medical equipment.
- Documented vital signs and health history for patients in clinic and hospital environments.
- Called and faxed pharmacies to submit prescriptions and refills.
- Scheduled appointments, registered patients and distributed sample pharmaceuticals as prescribed.
- Assisted with routine checks and diagnostic testing by collecting and processing specimens.
- Gathered forms and copied insurance cards to collect patient information for billing and insurance filing.
- Prepared initial patient charts for admission.
- Arranged surgeries with surgical center, confirming times with patients and preparing admission and consent forms.
Education
Associate of Science - Sociology And Behavioral Science
Sierra College
Rocklin, CA05.2023
Skills
- Motivational Leadership
- Client Interactions
- Creative Thinking
- Customer Care
- Social Media Platforms
- Behavior Identification
- Patient Management
- Scheduling and Coordinating
- Direct Patient Care
- OB/GYN Procedures
- Project Management
- Policy and Procedure Adherence
Timeline
Customer Care Concierge Support
Blue Shield Of CA
11.2018 - 08.2021
Eligibility Specialist II
Western Health Advantage
10.2017 - 06.2018
Claims Associate
Aerotek Staffing (River City Medical Group)
07.2017 - 10.2017
Patient Care Technician
Davita
05.2016 - 11.2016
Quality Assurance Auditor
Wolberg Michelson/ Blue Shield Of California
08.2014 - 01.2016
Medical Assistant
DR IRA JOHNER
04.2010 - 08.2014
Associate of Science - Sociology And Behavioral Science
Sierra College
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