Veronica Martinez
New Braunfels,TX
Summary
Dynamic professional with over 25 years of experience in administrative healthcare, insurance authorizations, and intake coordination, dedicated to delivering exceptional customer service and effective conflict resolution. Proven ability to navigate complex customer interactions with calm and strategic mediation techniques, ensuring diverse needs are met with precision. Recognized as a responsive and resilient team player, equipped with an adaptable and resourceful mindset that drives success in fast-paced environments. Committed to fostering positive relationships and enhancing operational efficiency through strong communication skills.
Overview
16
16
years of professional experience
Work History
Complex Customer Care Rep
UMR/GEHA
07.2024 - Current
- Assisting members and providers with benefits/eligibility
- Processing Claims
- Discussing Claims with providers & members
- Assisting with code look ups
- Assisting with searching for INN providers
- Trouble shooting members through the GEHA member portal
- Assisting the department with month-end eligibility process. Includes ensuring that each member has a PCP assignment, updating all new and terminated members and the processing and distribution of PCP and specialty E-lists
- Provides proper member eligibility to vendors, providers, and outside agencies
CSR-Specialty Benefits Coordinator 23/Billing Rep 23
United Healthcare Group
02.2022 - 06.2024
- Registration of members
- Providing Benefits
- Processing payments
- Submitting referrals to INN providers
Adult Scheduling Coordinator/Intake
Regency National Nursing & Rehab
12.2017 - 11.2021
- Processed Referrals to admit status
- Worked on daily scheduling for nurses, therapists, HH aides, MSW
- First point of contact with patients for demographic review, phone numbers, emergency contacts, etc
- Reported to the DON for any changes in scheduling
- Responsible for setting up Case Conference meetings & In-services
- Providing Active Census, discharge census and transfer census to the CEO and managers
- Obtained prior authorizations for services
Customer Service Representative
Sitel
08.2020 - 05.2021
- (part-time)
Adult Scheduling Coordinator
National Nursing & Rehab
08.2015 - 12.2016
- Processed Referrals to admit status
- Worked on daily scheduling for nurses, therapists, HH aides, MSW
- First point of contact with patients for demographic review, phone numbers, emergency contacts, etc
- Reported to the DON for any changes in scheduling
- Responsible for setting up Case Conference meetings & In-services
- Providing Active Census, discharge census and transfer census to the CEO and managers
- Obtained prior authorizations for services
Intake Coordinator/HR Representative
Be Healthy At Home
01.2014 - 12.2014
- First point of contact for all New Referrals
- Collected all patient information, demographics, insurance, emergency contacts
- Verification if insurance benefits
- Obtained first initial authorization for services & continued authorization
- Scheduled first initial visit for nursing, therapy
- Maintained all patients charts with current medical records
- Processed & sent orders to appropriate physicians for signature
- Person of contact for all new hires
- Validating licenses, CPR, auto insurance, references, background checks, providing clinicians information
- Of all CEU classes, making sure everyone was updated on compliance
- Managed all payroll, benefits
Admissions Coordinator
Warm Springs Specialty Hospital
05.2012 - 12.2013
- Responsible for development of admissions statistics
- Ensuring that all verification of eligibility, deductibles & co-pays are correct for billing
- Worked with Medicaid, Medicare, Medicare replacements and commercial insurances
- Obtained Authorization for LTAC services
- Processed patient information, demographics, insurance, emergency contacts
- Creating a professional & dependable atmosphere with Liasons, Insurance companies, Case Managers
- And other professionals
- Assisted with tours of our facility, providing information of the services we provided
Administrative Assistant to the Director of Nurses/Staffing Coordinator
Warm Springs Specialty Hospital
01.2012 - 10.2013
- Assisted DON with her calendar, scheduling meetings, in-services, conference calls
- Improved office efficiency with organization, communication and notifying employees of any changes
- Assisting HR with employee records, ensuring that nursing was up to date with CEU’s, CPR, BLS
- Competencies, licenses, and shot records
- Handled all staffing for AM & PM shifts, handled call ins, handled PRN staff, maintained all nursing hours
- & budgets
Unit Secretary
Baptist Medical Center
10.2009 - 11.2011
- Preformed a range of clerical skills
- Receiving & acknowledging physician orders, transcribed medical plan of care
- Knowledge in Medical terminology
- Preparing charts for new admissions
- Followed all standard precautions, greeted all patients & visitors
- Organized & created a good work environment
- Answered and assisted on answering any questions patients of families needed
Education
High School -
New Braunfels High School
New Braunfels, Tx11.1996
Diploma - Medical Assistant
National Institute of Technology
San Antonio, Tx10.1992
Skills
- Administrative & Clerical settings – payroll, staffing, the usage of Outlook, Microsoft Office, Excel, filing, copying, faxing, and eFax
- Programs – Kantime, Kinnser, Homecare Homebase, Allscripts, NaviHealth
- Knowledge of JACHO, HIPPA , Osha regulations
- Data entry
- Multitasking and organization
- Active listening
- Custom order management
- Billing coordination
- Decision-making
- Documentation and reporting
- Relationship building
- Time management
Additional Skills
- Knowledge of Lupas, new Medica
- Highly skilled in customer service, courteous, and obliging manner in person or on phone calls
- In-depth knowledge of multi- tasking environment
- Highly dedicated to the healthcare field as a service focused professional
Timeline
Complex Customer Care Rep
UMR/GEHA
07.2024 - Current
CSR-Specialty Benefits Coordinator 23/Billing Rep 23
United Healthcare Group
02.2022 - 06.2024
Customer Service Representative
Sitel
08.2020 - 05.2021
Adult Scheduling Coordinator/Intake
Regency National Nursing & Rehab
12.2017 - 11.2021
Adult Scheduling Coordinator
National Nursing & Rehab
08.2015 - 12.2016
Intake Coordinator/HR Representative
Be Healthy At Home
01.2014 - 12.2014
Admissions Coordinator
Warm Springs Specialty Hospital
05.2012 - 12.2013
Administrative Assistant to the Director of Nurses/Staffing Coordinator
Warm Springs Specialty Hospital
01.2012 - 10.2013
Unit Secretary
Baptist Medical Center
10.2009 - 11.2011
Diploma - Medical Assistant
National Institute of Technology
High School -
New Braunfels High School
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