Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic

Socorro H Padilla-Luna

Greenwood,IN

Summary

17 plus years bilingual health care professional Indiana Health Coverage Program Experience: 17 years Managing Member/Customer Satisfaction Experience: 17 years Member Call Center Experience: 6 years Managed Care Experience: 12 years Account/Vendor Management Experience: 12 years Coordinate and write materials for management: 6 years Create data reports for the staff and management. 6 years Collaborate with Providers, members with the proper materials for adequate coverage. 6 years Update huddle materials, member records, provider’s directions. 6 years Coordinate with vendors the proper information for members. 6 years Coordinate activities with the staff for engagement. Same for the management team. 6 years Outreach events and festivals for Medicaid Indiana. 10 years Provider Experience: 17 years Supervisor Experience: 9 years Data Analysis Experience: 6 years Medicare Program Experience: 1.5 years

Professional with robust experience in intake coordination, adept at managing high-volume caseloads and streamlining processes. Known for fostering strong team collaboration and adapting seamlessly to evolving priorities. Skilled in client assessment, conflict resolution, and effective communication, ensuring optimal outcomes. Consistently delivers results by leveraging organizational skills and proactive approach.

Overview

19
19
years of professional experience

Work History

Intake Supervisor

Centene Corporation
03.2022 - Current
  • Maximized performance by monitoring daily activities and mentoring team members.
  • Cross-trained existing employees to maximize team agility and performance.
  • Developed a strong company culture focused on employee engagement, collaboration, and continuous learning opportunities.
  • Achieved departmental goals by developing and executing strategic plans and performance metrics.
  • Boosted employee morale and reduced turnover through development and implementation of comprehensive rewards and recognition program.
  • Evaluated employee performance and conveyed constructive feedback to improve skills. We do 1-1's every month to go by their productivity.
  • Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement. I have been hiring, scheduling orientation and requesting access for all my employees since 2022. My former director Louis Sabater delegated all his resumes to me for review and hiring.
  • Cultivated positive rapport with fellow employees to boost company morale and promote employee retention.
  • Accomplished multiple tasks within established timeframes.
  • Completed bi-weekly payroll for 14 employees.

Referral Supervisor

Managed Health Services, Centene Corporation
01.2017 - Current
  • Oversee referral authorizations processes for all lines of business for the health plan
  • Collaborate with internal and external stakeholders for resolutions of prior authorizations
  • Motivate, coach, counsel, and supervise the daily functions of referral coordinator staff
  • Familiarized with multiple internal software programs
  • Process inpatient, elective, and delivery authorizations in accordance with State and managed care contractual agreements
  • Maintain knowledge of and ICD 10 and medical terminology for proper processing of authorizations
  • Process, respond, and review all prior authorization
  • Review and respond to complex issues and questions from providers
  • Conduct department reporting on production on weekly, monthly basis and on a as needed basis
  • Monitor phone, fax, CRM and after call queues for workflow

Health Advantage Supervisor

Eskenazi Health
10.2014 - 12.2017
  • Supervised staff to ensure department and company goals were achieved.
  • Provided ongoing training to staff to ensure staff had up to date knowledge of health coverage programs. I will train each one of my reviewers our charity care system.
  • Collaborated with upper-level management to implement effective, innovative, and cost-effective processes to increase productivity. I used to have meetings with my director every week.
  • Managed customer management software operations for the Health Advantage program
  • Followed up on critical action items and reported to appropriate departments to encounter a resolution. I will reach out to shelters, FQHC's for additional support.
  • Established rapport with internal and external stakeholders to create education and awareness of the Health Advantage Program. I used to have communication with shelters, FQHC's, Latino support groups and Outreach coordinators here in Marion County.
  • Reviewed, researched, denials and appeals of participants eligibility inquiry. All denials will come to me for a second review and a possible overturn.
  • Provided educational sessions to the community regarding Health Advantage and Affordable Care Act program updates. Every year at Eskenazi health we will have a ACA fair.

Enrollment Coordinator

Health & Hospital Corporation of Marion County
11.2012 - 10.2014
  • Complied with all policies and regulations for Indiana Health Coverage Programs to facilitate the enrollment process for those applying for the Healthy Indiana Plan
  • Followed Health Advantage policies guidelines to determine eligibility for those applying for the Health Advantage Program
  • Coordinated and distributed the Health Advantage applications received through Indeapp system to Health Advantage Reviewers
  • Resolved inquiries of Health Advantage applications for financial reviewers and members
  • Conducted Affordable Care Act community outreach to create education and awareness of health insurance programs rules and regulations
  • Assisted Program Manager with special projects as assigned

Health Advantage Reviewer

Health & Hospital Corporation of Marion County
12.2010 - 11.2012
  • Adhered to Health Advantage guidelines to determine eligibility of applicants for Health Advantage Program
  • Maintained understanding of Indiana Health Coverage Programs
  • Established rapport with financial reviewers at local enrollment centers
  • Assisted with the communication to Spanish speaking Health Advantage members
  • Resolved eligibility issues for Health Advantage applicants
  • Achieved daily productivity quota established by the department

Transportation Specialist

MDwise
06.2007 - 12.2010
  • Maintained strong relationships with external transportation vendors
  • Coordinated transportation requests for all MDwise members
  • Established rapport with MDwise delivery systems representatives
  • Processed monthly transportation invoices for all transportation vendors
  • Resolved non compliant transportation requests submitted by MDwise members
  • Assisted Transportation Manager to create innovative and effective workflow processes for transportation requests received

Bilingual Customer Service Representative

MDwise
06.2006 - 06.2007
  • Received incoming telephone calls and conducted conferences with members and providers. We received approximately 100 calls daily.
  • Provided prompt and courteous responses to inquires as defined by department standards
  • Served as member’s or provider’s advocate to resolve outstanding issues
  • Recognized potential quality issues and processed information accordingly
  • Maintained strong understanding of Indiana Health Coverage Program policies and procedures
  • Adhered to Office of Medicaid Policy and Planning guidelines to preform job functions

Education

Bachelor of Arts - Graphic Design

Universidad Del Valle De Atemajac
Guadalajara Jalisco Mexico
01.2001

Certificate of Technical Studies - Pharmacy

Purdue University
West Lafayette, IN
07-2025

Skills

  • Professionalism and ethics
  • Staff training and development
  • Policy enforcement
  • Teamwork and collaboration
  • Attention to detail
  • Problem-solving abilities
  • Reliability
  • Recruitment and hiring
  • Professionalism
  • Adaptability

Languages

English
Native or Bilingual

Timeline

Intake Supervisor

Centene Corporation
03.2022 - Current

Referral Supervisor

Managed Health Services, Centene Corporation
01.2017 - Current

Health Advantage Supervisor

Eskenazi Health
10.2014 - 12.2017

Enrollment Coordinator

Health & Hospital Corporation of Marion County
11.2012 - 10.2014

Health Advantage Reviewer

Health & Hospital Corporation of Marion County
12.2010 - 11.2012

Transportation Specialist

MDwise
06.2007 - 12.2010

Bilingual Customer Service Representative

MDwise
06.2006 - 06.2007

Bachelor of Arts - Graphic Design

Universidad Del Valle De Atemajac

Certificate of Technical Studies - Pharmacy

Purdue University