TIANA MAZARIEGOS
Spanaway,WA
Summary
Results-driven professional with a decade of experience in healthcare leadership and team management. Expertise in organizational development and promoting collaborative environments. Focused on leveraging strategic insights to achieve organizational goals and support growth.
Overview
11
11
years of professional experience
Work History
Care Coordinator II
Coordinated Care Apple Health Connections - Centene
01.2024 - Current
- Provide ongoing support to foster families, including crisis intervention, counseling, and advocacy
- Work with social workers, healthcare providers, and educators to address the needs of foster children and families
- Ensure adherence to all state and federal regulations regarding foster care placements and procedures
- Maintain accurate records and documentation of placements, progress reports, and case notes
- Engage with members to promote preventive care, wellness programs, and health education
- Coordinate with healthcare providers to ensure seamless delivery of services and care coordination
- Established trust with clients by accurately addressing their concerns and offering appropriate resolutions based on their needs.
- Worked with homeless, diverse and low-income populations to assist in coping with mental health, substance abuse and recovery issues.
- Conducted follow-ups with clients to assess progress and address any emerging needs or concerns.
- Provided compassionate assistance during challenging situations, helping patients navigate complex medical systems more easily.
Program Coordinator II
Centene, Superior Health
01.2022 - 01.2024
- Processed medical claims using advanced billing software to ensure accurate and timely submissions.
- Reviewed patient records for completeness, verifying coding accuracy against established guidelines.
- Assisted in resolving billing discrepancies through effective communication with healthcare providers and insurance companies.
- Trained new team members on coding protocols and billing procedures, fostering a collaborative work environment.
- Led initiatives for quality assurance audits, improving overall coding accuracy and reducing claim denials significantly.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Coordinated with healthcare providers to obtain necessary clinical documentation for case reviews.
Program Coordinator I
Centene, Superior Health
01.2020 - 01.2022
- Managed and audited insurance claims for accuracy and compliance.
- Processed and verified patient insurance information for medical services.
- Reviewed and approved authorization requests for medical treatments.
- Performed data entry and maintained detailed records of authorization approvals.
- Communicated with healthcare providers and insurance companies to resolve authorization issues.
Temp Worker - Program Coordinator
Total Medical Staffing
01.2020 - 01.2021
- Provided administrative support to a team of project managers
- Analyzed program data to identify trends and opportunities for improvement
- Communicated authorization status to patients and healthcare staff.
- Maintained detailed records of authorization requests and approvals.
- Handled inbound customer inquiries and resolved issues in a timely manner.
- Collaborated with team members to effectively handle complex patient situations.
Clinical Manager
Epic Vision Eye Centers
01.2018 - 01.2020
- Managed a team of healthcare professionals and coordinated patient care in a hospital setting.
- Facilitated staff training and development programs to enhance clinical skills.
- Utilized electronic health records to track patient progress and document treatment plans.
- Participated in quality improvement initiatives to enhance patient outcomes and satisfaction.
- Ensured compliance with all regulatory requirements and maintained high standards of patient safety and quality of care.
- Managed clinic operations, including staff scheduling and patient flow.
- Oversaw inventory management and ordering of supplies.
Certified Pharmacy Technician
CVS Pharmacy
01.2015 - 01.2018
- Managed pharmacy inventory and accurately dispensed medications to patients.
- Processed insurance claims and handled prescription refills efficiently.
- Provided exceptional customer service and answered patient inquiries.
- Collaborated with healthcare providers to ensure proper medication administration.
- Maintained a clean and organized work environment to comply with safety regulations.
- Utilized pharmacy software to update patient profiles and track medication history.
Education
Healthcare Administration Management - Healthcare
Southern New Hampshire
New Hampshire, OHSkills
- Managed a caseload of 60 cases weekly, coordinating care plans and collaborating with healthcare providers, insurance companies, and patients
- ICD-10 knowledge
- Staff management
- Complex Problem-solving
- Staff development
- Operations management
LANGUAGES
Spanish | Native
Accomplishments
Able to achieve 3 promotions in a span of 5 years while employed at Centene
REMOTE EXPERIENCE
My remote work experience has provided me with strong skills in using a variety of communication and collaboration tools to facilitate effective project coordination and ensure timely completion of tasks. I excel at maintaining productivity and promoting positive team dynamics in a remote setting, which contributes to a results-oriented work environment. Additionally, I am proficient in using platforms such as Microsoft Teams, Outlook, Zoom, various healthcare systems like Filnet, Faxcom, Trucare Cloud and Classic, as well as Microsoft Excel and Word, and Google Docs.
Timeline
Care Coordinator II
Coordinated Care Apple Health Connections - Centene
01.2024 - Current
Program Coordinator II
Centene, Superior Health
01.2022 - 01.2024
Program Coordinator I
Centene, Superior Health
01.2020 - 01.2022
Temp Worker - Program Coordinator
Total Medical Staffing
01.2020 - 01.2021
Clinical Manager
Epic Vision Eye Centers
01.2018 - 01.2020
Certified Pharmacy Technician
CVS Pharmacy
01.2015 - 01.2018
Healthcare Administration Management - Healthcare
Southern New Hampshire
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