Sylvia Ledesma
Bellflower,CA
Summary
Dynamic Medical Management Assistant with a proven track record at SCAN Health Plan, excelling in authorization management and fostering strong relationships. Demonstrated expertise in maintaining HIPAA compliance and enhancing customer service through effective communication. Skilled in multitasking and attention to detail, significantly contributing to successful CMS and DHCS audits.
Overview
30
30
years of professional experience
Work History
Medical Management Assistant
SCAN Health Plan
06.2001 - 09.2024
- Provided administrative support during CMS and DHCS audits ensuring accuracy and timely completion..
- Prepared and charted data and metrics for detailed status reports.
- Fostered strong relationships with Hospitals,Providers, and SNF's by providing exceptional customer service during interactions via phone or email correspondence.
- Maintained a high level of confidentiality while handling sensitive information protecting a members PHI.
- HIPAA compliant professional.
Authorization Assistant
Tenet Healthcare Corporation
02.1999 - 05.2001
- Phone queue telephonic authorization processing, transfer calls, or relay messages to appropriate personnel.
- Contributed to a positive work environment with strong interpersonal skills and proactive teamwork attitude.
- Worked closely with management to provide effective assistance for specific aspects of business operations.
Mailroom Clerk
Pacific Care of California
05.1994 - 11.1998
- Sorted CMS 1500 professional and UB-04 facility claims then assigned to claims processors.
- Scanned all completed claims to load onto microfish.
- Multitasked effectively in a fast-paced environment, prioritizing tasks appropriately to meet daily deadlines consistently.
- Assisted in training new staff members, imparting best practices for effective mailroom operations and fostering a collaborative work environment.
- Improved mail processing efficiency by accurately sorting and distributing incoming mail to appropriate departments.
Education
High School Diploma -
La Mirada High School
La Mirada, CACerritos College
Norwalk, CASkills
- Authorization management
- Relationship building
- Excellent communication
- Multitasking
- Teamwork and collaboration
- Attention to detail
- HIPPA compliant professional
Accomplishments
- Received a Gold Star 100% accuracy on Dean Vaughn's Medical Terminology
Timeline
Medical Management Assistant
SCAN Health Plan
06.2001 - 09.2024
Authorization Assistant
Tenet Healthcare Corporation
02.1999 - 05.2001
Mailroom Clerk
Pacific Care of California
05.1994 - 11.1998
High School Diploma -
La Mirada High School
Cerritos College
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