STEPHANIE ARROYO GARCIA

• Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility.
• Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census.
• Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management (CM) assessment. Perform transition of care duties to include but not limited to, contact the member’s attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs.
• Coordinate services with community based organizations. Attend marketing and outreach meetings as directed to represent the plan. Produces and mails routine CM letters and program educational material.
• Data enter assessments and authorizations into the system.

• Multitask between different software programs and databases
• Maintain timeliness and productivity with varying caseload
• Organize caseload based on time frames
• Research and telephonic outreach to initiate activities that promote member access to care through community resources, services and programs
• Provides timely and accurate resolution of inquiries and issues
• Provides superior quality outcomes by taking ownership of issues to ensure timely resolution or follow-up
• Provides superior, professional, and courteous service to customers
• Established and implemented sustainable and diverse funding strategies to support financial and operational objectives of organization

• Organized and retrieved patient information for medical practitioners
• Responded to patient inquiries and problems and relayed information to leadership
• Retrieved patient information, inputted data to internal database
• Handled high volume of incoming and outgoing calls to assist patient needs and to pre- register patients before appointments
• Confirmed and scheduled patients for radiology services to maintain 95% appointment fulfillment
• Called insurances to obtain pre-auth, eligibility
• Kept reception area clean and neat to give visitors positive first impression.
• Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
• Confirmed appointments, communicated with clients and updated client records.
• Answered central telephone system and directed calls accordingly.
• Resolved customer problems and complaints.
• Responded to inquiries from callers seeking information.
• Managed multiple tasks and met time-sensitive deadlines.
• Provided clerical support to company employees by copying, faxing and filing documents.

• Ensured any release of information requests were HIPAA compliant
• Maintained all medical records information organized
• Separated each account by individual, scanned documents and reviewed number of each account to enter them on system.
• Worked with internal staff to process documents and sent for closing.
• Provided assistance with inbound and outbound document processes, document sorting, logging and work order creation.
• Inputted settings onto scanner computer screen by manipulating mouse or typing from keyboard.
• Followed security and privacy policies, standards and guidelines to protect informational assets of company and customers.
• Scanned, filed and transmitted various documents and adhered to digital filing procedures.

• Organized and cleaned assigned sections by sanitizing and cleaning table, counter and kitchen surfaces.
• Operated cash register for cash, check and credit card transactions with excellent accuracy levels.
• Worked flexible schedule and extra shifts to meet business needs.
• Collected and authorized payments of guests.
• Worked closely with shift manager to solve problems and handle customer concerns.
• Maintained secure cash drawers, promptly resolving discrepancies in daily totals
• Greeted over 100 clients per day