Valerie Torres
Rialto,CA
Summary
Experienced Provider Relations Representative with over 14 years in healthcare administration, patient coordination, and insurance verification. Expertise in building strong provider relationships, resolving network issues, and maintaining regulatory compliance. Manages high call volumes with accuracy and efficiency, ensuring positive outcomes for both providers and members.
Overview
15
15
years of professional experience
Work History
Provider Relations Representative
Ear Professionals Network
Eden Prairie, Minnesota
12.2021 - Current
- Serve as primary point of contact for providers regarding network participation, benefits, and operational issues.
- Maintain strong provider relationships through effective communication and timely issue resolution.
- Review and verify documentation to ensure compliance and minimize payment delays.
- Manage an average of 35+ provider calls daily while consistently meeting quality and productivity standards.
- Collaborate with internal departments to resolve complex provider concerns and improve service delivery.
- Educate providers on policies, procedures, and system updates to support network success.
Patient Coordinator
Smile Design Dentistry & Braces
Rialto , CA
07.2011 - 12.2021
- Coordinated patient scheduling, treatment planning, and insurance verification to streamline patient flow and improve service delivery.
- Managed incoming calls, appointment scheduling, and patient communications.
- Assisted patients with financial arrangements and insurance benefits to enhance access to care and address treatment-related inquiries.
- Managed insurance billing, claims submission, and payment collection to ensure timely revenue recovery and minimize delays.
- Maintained accurate patient records and ensured compliance with office and healthcare regulations.
- Trained and mentored new employees on office procedures and customer service standards.
- Supported office operations through inventory management and administrative coordination.
Education
Dental Assistant Certification - Dental
Everest College
San Bernardino, CA06-2010
High School Diploma -
Rialto High School
Rialto06-2003
Skills
- Provider Relations
- Provider Network Support
- Healthcare Administration
- Medical Billing & Claims
- Insurance Verification
- Documentation Review
- HIPAA Compliance
- Customer Service Excellence
- Relationship Management
- Conflict Resolution
- Problem Solving
- Training & Mentoring
- Multitasking
Timeline
Provider Relations Representative
Ear Professionals Network
12.2021 - Current
Patient Coordinator
Smile Design Dentistry & Braces
07.2011 - 12.2021
Dental Assistant Certification - Dental
Everest College
High School Diploma -
Rialto High School