Alejandra Rosales
Calexico,CA
Summary
Skilled Case Manager with a proven track record at McKesson, adept in Care Coordination and building strong relationships. Leveraged regulatory compliance and a positive attitude to enhance patient support, achieving significant improvements in client outcomes. Expert in data analysis and health history documentation, consistently delivering high-quality care and efficient service.
Overview
9
9
years of professional experience
Work History
Case Manager
McKesson
Phoenix, AZ
03.2021 - Current
- Provided customer service to patients and their families, responding to inquiries in a timely manner.
- Verified patient insurance coverage and eligibility for services.
- Performed data entry of patient information into electronic health records systems.
- Ensured compliance with organizational policies, procedures, and protocols related to patient support services.
- Facilitated communications between office staff, physicians, nurses, payers, vendors.
- Answered phones promptly and professionally while managing call volume efficiently.
- Answered multi-line phone system and accurately routed calls to correct individuals.
- Reviewed patient data and researched to fill in missing insurance and physician information.
- Assessed clients' needs, developed service plans and monitored progress towards goals.
- Facilitated communication between clients, families, caregivers, social services and other agencies to ensure client needs were met.
- Maintained accurate case records and documentation according to agency guidelines.
- Compiled reports on cases and submitted them to supervisors as required.
- Adhered to ethical principles and standards to protect clients' confidential information.
- Collaborated with healthcare team to improve care quality, reduce costs and gauge patient progress.
- Maintained confidentiality and adhered to professional ethics and standards.
- Evaluated program effectiveness and suggested improvements based on client outcomes.
- Developed and maintained relationships with community resources and service providers.
- Utilized case management software and databases for efficient information tracking.
- Advocated on behalf of clients to secure necessary services and support.
- Handled administrative procedures to meet objectives set by boards of directors or senior management.
- Provided feedback on employee performance based on observed results during training sessions.
- Analyzed data from pre-and post-training assessments to measure effectiveness of training programs.
- Recommended changes or improvements in existing training processes as needed.
- Resolved any issues raised by participants during the training session in a timely manner.
- Encouraged open communication among participants by facilitating conversations around relevant topics related to course material.
- Trained newly hired top talent to fill key positions and maximize productivity.
- Provided constructive feedback and positive reinforcement to keep trainees motivated.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Answered inbound calls, chats and emails to facilitate customer service.
Intake Clerk
Pioneers Memorial Healthcare District
Brawley, California
03.2016 - 03.2021
- Received and processed incoming client referrals for intake assessment.
- Conducted initial screenings to determine eligibility for services.
- Updated and maintained accurate records of client information in database.
- Maintained confidentiality of client information according to HIPAA guidelines.
- Greeted customers warmly and made them feel welcome.
- Answered incoming calls, redirected callers to the appropriate personnel or department and took messages as needed.
- Assisted with scheduling appointments for clients and visitors.
- Maintained an organized reception area and ensured that all guests were attended to promptly.
- Managed incoming and outgoing mail, courier services, faxes and other correspondence.
- Performed data entry into computer systems to maintain accurate records of customer information.
- Provided administrative support such as filing documents, photocopying and scanning materials.
- Provided excellent customer service by responding quickly to inquiries via phone or email in a professional manner.
- Resolved any customer complaints or issues in a timely fashion following established protocols.
- Handled payment processing and provided customers with receipts and proper bills and change.
- Received incoming calls and coordinated with staff to fulfill customer requests.
- Answered multi-line phone system and managed calls by routing to proper extensions or taking messages.
- Collected patient demographic information, verified insurance coverage, and updated records as necessary.
- Assisted with scheduling appointments, verifying benefits and authorizations for procedures.
- Responded to inquiries from patients, families, physicians, and other healthcare personnel.
- Maintained confidentiality of patient information in accordance with HIPAA regulations.
- Verified insurance eligibility through online portals or by phone calls.
- Handled incoming faxes related to admissions, discharges, transfers, pre-certifications, authorizations.
- Updated patient information in database regularly to ensure accuracy of records.
- Screened patients before and during admissions processes.
- Greeted patients, determined purpose of visit and directed to appropriate staff.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Answered telephones and directed calls to appropriate medical or adminstrative staff.
- Managed front office customer service, appointment management, billing and administration tasks to streamline workflow.
Volunteer
Pioneers Memorial Healthcare District
Brawley, CA
09.2015 - 03.2016
- Provided assistance to staff in the daily operations of the organization.
- Organized and maintained records of volunteer hours and donations.
- Assisted with fundraising efforts, including event planning and donor outreach.
- Attended weekly meetings to discuss progress and future initiatives.
- Collaborated with other volunteers to create a positive work environment.
- Greeted visitors upon arrival at the office, answered phone calls, and responded to emails.
- Supervised youth volunteers while they completed their assigned tasks on site.
- Followed directions from supervisors and completed tasks within appropriate timeframe.
- Offered support and assistance to community members.
- Greeted guests and offered assistance in finding specific departments or personnel.
- Built partnerships with related organizations to develop support and gain greater attention for important issues.
Education
Some College (No Degree) - Medical Social Work
Kaplan College
Palm Springs, CA12-2015
Skills
- Care Coordination
- Regulatory Compliance
- Performance Tracking
- Referral Coordination
- Patient support
- Family Education
- Health History Documentation
- Positive Attitude
- Patient Assessments
- Data Entry and Analysis
- Case Documentation
- Relationship Building
Languages
English
Full Professional
Spanish
Full Professional
Timeline
Case Manager
McKesson
03.2021 - Current
Intake Clerk
Pioneers Memorial Healthcare District
03.2016 - 03.2021
Volunteer
Pioneers Memorial Healthcare District
09.2015 - 03.2016
Some College (No Degree) - Medical Social Work
Kaplan College