Vicky Perez
South Gate,CA
Summary
To seek and maintain a full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. As well as an energetic Healthcare professional dedicated to providing top-quality, patient-centered care. Highly skilled in addressing acute and chronic conditions. Resourceful navigation of complex healthcare environments to optimize patient care.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Utilization Management Coordinator
PIH Health Hospital Downey
Downey
06.2024 - 08.2024
- Utilized computer systems such as EMRs, UM software programs and databases to access information relevant to the review process.
- Collaborated with providers to obtain required clinical information, supporting prior authorization determinations and individual inquiries.
- Contributed to appeals process by providing pertinent clinical information upon request from appeals department personnel.
- Support UM Dept. with ensuring timeliness of outpatient and inpatient authorization or referrals.
- Managed appeals for denied services, providing additional information to support medical necessity.
- Processed Authorizations
- Utilized computerized Resource Electronic Health Record (EHR) system.
- Contacted insurance carriers to obtain authorizations for services delivered to patients.
- Referred cases to secondary review for failure to meet criteria.
- Demonstrated strong problem-solving skills, resolving issues and performed troubleshooting efficiently and effectively.
Patient Access Rep Transfer Center/Intake Coordinator/ - Remote
Memorial Hospital of Gardena
Gardena, CA
10.2023 - 01.2024
- Processed patient admissions, registrations, transfers, and discharges according to established procedures.
- Verified insurance coverage for services provided by the facility. IPA, HMO, M Cal
- Ensured accuracy of all data entered into computer system.
- Scanned documents into electronic medical records system.
- Maintained confidentiality of all patient information in accordance with HIPAA regulations.
- Answered phones promptly in a professional manner.
- Managed incoming faxes related to patient registration processes.
- Applied HIPAA privacy and security regulations while handling patient information.
- Collaborated with clinical and administrative staff to meet patient needs.
- Organized timely and accurate referrals to help patients obtain health care services and access available resources.
- Documented patient counters in hospital system and initiated follow-up actions.
- Call center. Answered and assisted more than 50 calls per day.
Intake Coordinator/ Remote
OSO Home Care
Irvine, CA
08.2022 - 02.2023
- Reception role as needed
- Customer service
- Conducted patient intake interviews to collect medical information for billing and insurance details.
- Scheduled and confirmed patient appointments for diagnostic, surgical and consultation services.
- Answered phone calls to provide assistance, information and medical personnel access.
- Compiled physical and digital documents, charts and reports.
- Updated group medical records and technical library to promote smooth office operations.
- Maintained positive attitude and effectively de-escalated clients during crisis situations.
- Maintained accurate records of client intakes in electronic database system.
- Provided information and resources to individuals, families, and groups seeking assistance.
- Answered and logged incoming inquiries via phone, fax and email.
- Scheduled appointments for patient consultations, tests and procedures.
- Assisted in the development of referral processes and procedures.
- Maintained accurate records of all referrals, including contact information and follow-up activities.
Discharge Planner/Coordinator
Community Hospital Of Huntington Park
Huntington Park, CA
05.2021 - 08.2022
- Worked with utilization review to establish prior authorization for timely discharges.
- Coordinated travel arrangements and contacted family with travel information.
- Facilitated timely referrals to alternate levels of care and assisted family or guardian with completion of applications.
- Worked with medical teams, patients and families to implement effective treatment plans.
- Organized clinical documentation, treatment plans, and referrals.
- Completed psychosocial evaluations and needs assessments.
- Coordinated individualized discharge plans to manage safe transition back into community and home environments.
- Maintained energy and enthusiasm in fast-paced environment.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Coordinated program referrals for community-based resources.
- Updated treatment plans on monthly basis with latest intervention strategies and progress notes.
- Used coordination and planning skills to achieve results according to schedule.
- Manage Medicare program
- Follow up/Call Medicare patients within 90 day discharge
- manage the daily Medicare census for discharge calls
- Created a safe environment for discharged patients by providing information about safety precautions at home and in the community.
- Assisted in the coordination of services needed after hospitalization such as home health care, durable medical equipment, transportation.
- Coordinated community resources such as housing, food banks, financial assistance programs. for discharged patients who need additional support after leaving the hospital.
- Participated in multidisciplinary team meetings when determining appropriate levels of care prior to discharge.
- Provided education, support, and guidance to families of discharged patients.
- Maintained timely communication with physicians regarding patient's progress during the course of treatment prior to discharge.
- Assisted families in understanding insurance coverage options so they can make informed decisions about necessary treatments post-hospitalization.
- Reviewed medication regimens with pharmacist and physician upon discharge in order to ensure accuracy and appropriateness of medications prescribed.
- Facilitated referrals for follow up appointments with specialists or primary care providers post-discharge.
- Coordinates and assists with patient appointments as needed and notifies patient of authorization status.
- Create and maintains tracking reports for follow up calls on a weekly basis within 90 day period
- Follow up that needs are being met, services are being delivered tp patient
- Follow up and help solve with any issues patient is experiencing.
- Provided follow up phone calls and home visits post-discharge in order to monitor progress of discharged patients.
- Educated families on available resources in order to help them better understand their loved one's diagnosis and treatment plan before being discharged from the hospital.
Rehabilitation Aide
Altamed PACE
South Gate, Ca
11.2007 - 06.2019
- Contributed to a positive work environment by providing encouragement and emotional support to patients.
- Assisted patients with recreational activities
- Provided support PACE program departments
- Assisted with the development of individualized rehabilitation plans for each patient.
- Noted physical and emotional changes in patients and detailed in medical records.
- Maintained accurate records of patient progress and treatment plans.
- Instructed patients on proper use of medical equipment such as wheelchairs, walkers and canes.
- Communicated regularly with other members of the healthcare team regarding patient care needs.
- Provided physical support to individuals with limited mobility during transfers and ambulation.
- Performed range of motion exercises with patients to increase their flexibility and strength.
- Encouraged clients to participate in recreational activities to improve their social skills.
- Assisted patients with prosthetic or orthotic devices.
- Helped patients prepare for treatment sessions with guidance to changing rooms and rehabilitation spaces.
- Supported ADLs and room transfers for in-patient procedures.
- Assisted with gait training and supported patient safety in cases of total loss of balance.
- Guided patients in passive ROM exercises and instructed movements to assist therapist.
- Documented patient progress, treatments, and data in charts.
- Instructed patients on how to use, remove and put on external assistive devices.
- Cleaned therapy equipment following each appointment to achieve sanitary regulations.
- Emailed necessary intake forms to new clients before first appointment.
- Helped transport frail or disabled patients to different treatment areas.
- Took calls and scheduled appointments for patients.
- Recorded body measurements and fit patients for braces, slings and crutches.
Education
High School Diploma -
South Gate Senior High School
South Gate, CA06.2002
Skills
- Utilization Management
- Refferals
- Reception
- Admitting processes
- Assessing needs
- Goal Setting
- Good listening skills
- First Aid/CPR
- MS Office
- Planning and Coordination
- Teambuilding
- Scheduling
- Patient Care
- Patient Assistance
- Medical Terminology
- Pre-authorizations
- Appointment Scheduling
- Appointment Reminders
- Good telephone etiquette
- Compassion
- Time Management
- Community Resource Referral
- Charting and Clinical Documentation
- Customer Service
- Schedule Coordination
- Multitasking and Prioritization
- Phone and Email Etiquette
Certification
- Certified Nursing Assistant- October 2005
- Physical Therapy Aide- June 2009
Timeline
Utilization Management Coordinator
PIH Health Hospital Downey
06.2024 - 08.2024
Patient Access Rep Transfer Center/Intake Coordinator/ - Remote
Memorial Hospital of Gardena
10.2023 - 01.2024
Intake Coordinator/ Remote
OSO Home Care
08.2022 - 02.2023
Discharge Planner/Coordinator
Community Hospital Of Huntington Park
05.2021 - 08.2022
Rehabilitation Aide
Altamed PACE
11.2007 - 06.2019
High School Diploma -
South Gate Senior High School