SOL RODRIGUEZ
OAKLAND,CA
Summary
Detail-oriented administrative professional with experience in healthcare settings, specializing in patient intake, insurance verification, and billing. Proficient in managing high-volume front office operations, scheduling, and maintaining accurate medical records. Skilled in identifying payor sources, navigating government programs, and conducting financial consultations. Strong collaborator with internal teams and external stakeholders, ensuring seamless billing, payments, and client coverage while maintaining professionalism and confidentiality in fast-paced environments.
Overview
26
26
years of professional experience
Work History
Patient Coordinator
Inview Imaging
06.2023 - 01.2024
- Manage all front desk operations, including answering phones, greeting patients, and handling inquiries.
- Schedule patient appointments efficiently to optimize workflow and reduce wait times.
- Perform patient intake by gathering accurate demographic and insurance information.
- Assist technologists with post-appointment follow-up, ensuring patients understand next steps and any required further care.
- Maintain patient records and ensure timely updates within the healthcare system.
- Provide exceptional customer service to create a welcoming and supportive environment for all patients.
- Collaborate with healthcare staff to streamline front desk processes and improve overall patient experience.
Provider Enrollment Coordinator
Alameda Health System
08.2020 - 12.2022
- Assisted providers transitioning from OakCare Medical Group to AHS by communicating login instructions and enrollment procedures via email.
- Verified provider credentials to ensure compliance with regulatory standards.
- Enrolled providers in Medi-Cal and Medicare programs to facilitate billing for services rendered.
- Ensured providers' license numbers were accurately integrated into the AHS system to meet billing requirements.
- Collaborated with internal teams to streamline enrollment processes and enhance overall operational efficiency.
- Maintained up-to-date records of provider enrollments and credentialing status.
Patient Services Representative
Alameda Health System
02.2022 - 08.2022
- Maintained patient confidentiality by adhering to HIPAA regulations and diligently updating records as needed.
- Resolved patient complaints promptly, demonstrating empathy and understanding while seeking mutually beneficial solutions.
- Managed high call volume, prioritizing urgent issues and directing calls appropriately for optimal resolution.
- Provided exceptional customer service to build strong relationships with patients, leading to increased loyalty and return visits.
Office Associate
UCSF Benioff Children's Hospital Oakland
06.2021 - 12.2021
- Improved patient care coordination by proactively communicating with insurance companies, laboratories, and other specialists.
- Reduced wait times for patients by prioritizing urgent cases when scheduling appointments or making follow-up calls for ongoing care needs.
- Enhanced patient satisfaction by efficiently managing appointment scheduling and maintaining accurate medical records.
- Promoted patient well-being by addressing inquiries regarding appointment scheduling, medications, and test results in a timely manner.
Eligibility Specialist
Alameda Health System
04.2002 - 07.2018
- Enhanced patient satisfaction by providing timely and accurate eligibility determination for various assistance programs.
- Reduced errors in eligibility determinations by maintaining thorough knowledge of Medicare, Medi-Cal, HealthPac, Presumptive Eligibility Medi-Cal,CHDP Gateway Program, Breast and Cervical Cancer Diagnostic and Treatment Medi-Cal guidelines and regulations.
- Evaluated financial documents to accurately assess income levels, assets, expenses, and other relevant factors impacting patient eligibility status.
- Managed Care Plans, Medi-Cal Managed Care Programs, Charity Care Program, private insurance and workers compensation verification/authorization processes and other related duties as required.
Patient Financial Counselor
Children's Hospital Oakland
09.2004 - 07.2008
- Identified payor sources within 24 hours of admission.
- Verified accurate financial and demographic information for all inpatient accounts.
- Confirmed insurance eligibility, benefits, and coverage for all admissions.
- Conducted financial consultations with parents/guardians, explaining obligations.
- Referred clients to government programs or assisted with charity applications when needed.
- Screened patient pay clients and monitored Medi-Cal application process for completeness.
- Determined coverage status and made CCS referrals when appropriate.
- Collaborated with Patient Accounting to prevent or reverse technical denials.
- Recommended payment arrangements or charity support based on financial circumstances.
- Professionally interacted with parents, providers, staff, discharge planners, and outside facilities to maximize client coverage.
- Adhered to departmental policies, quality assurance programs, and patient confidentiality standards.
Patient Account Representative
Children's Hospital Oakland
02.2000 - 04.2002
- Assisted in Patient Pay Unit, Outpatient Medi-Cal Billing, and Cash Posting departments.
- Identified payor sources through client applications to state and county programs (Medi-Cal, CHDP, Prop 99, Charity Care).
- Took collector action for non-compliant clients, establishing payment plans or referrals to collection agencies for delinquent accounts.
- Managed outpatient Medi-Cal billing by coding and reconciling unbillable claims due to ICD-9 and CPT code errors.
- Posted insurance payments, contractual write-offs, and copayments based on explanation of benefits.
- Processed monthly payments and reimbursed client credits.
Medical Receptionist
Johnson Medical Group
06.1998 - 06.1999
- Performed all front office and clerical duties.
- Registered patients manually and completed insurance verification and chart preparation quickly and efficiently.
- Scheduled appointments and managed phone calls for a busy office with multiple doctors and high patient volume.
- Filed and prepared medical records for other medical offices and attorneys.
Education
Vocational School Certificate - Clerical Occupations
Western Association of Schools and Colleges
Imperial Beach, CA01.1998
Vocational School Certificate - Medical/Dental Clerical Occupations
San Diego Regional Occupation Program
Imperial Beach, CA01.1998
High School Equivalency Diploma - General High School Curriculum
Western Association of Schools And Colleges
Imperial Beach, CA01.1997
Skills
Data Entry
Effective communication skills
Microsoft Office
Telephone Etiquette
Expert Knowledge in Medi-Cal verification systems
Expert Knowledge in Insurance Verification Platforms (Availity, CalWin HealthPac) and Electronic Health Record (EHR) Systems (Epic, NextGen)
Cultural Competency
Teamwork and Collaboration
Time Management
Attention to Detail
Languages
Spanish
Native or Bilingual
Timeline
Patient Coordinator
Inview Imaging
06.2023 - 01.2024
Patient Services Representative
Alameda Health System
02.2022 - 08.2022
Office Associate
UCSF Benioff Children's Hospital Oakland
06.2021 - 12.2021
Provider Enrollment Coordinator
Alameda Health System
08.2020 - 12.2022
Patient Financial Counselor
Children's Hospital Oakland
09.2004 - 07.2008
Eligibility Specialist
Alameda Health System
04.2002 - 07.2018
Patient Account Representative
Children's Hospital Oakland
02.2000 - 04.2002
Medical Receptionist
Johnson Medical Group
06.1998 - 06.1999
Vocational School Certificate - Clerical Occupations
Western Association of Schools and Colleges
Vocational School Certificate - Medical/Dental Clerical Occupations
San Diego Regional Occupation Program
High School Equivalency Diploma - General High School Curriculum
Western Association of Schools And Colleges
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