william torres
Pico Rivera,California
Summary
Results-oriented Claims Processor with experience optimizing data workflows for accuracy and efficiency. Expert in streamlining processes with Microsoft Excel and proprietary software. Strong problem-solving skills and commitment to meeting performance goals. Pursuing opportunity as Supervisor of Administrative Services in Kaiser Permanente Occupational Medicine.
Overview
2027
2027
years of professional experience
Work History
Worker's Comp Processor I
Kaiser Permanente
05.2017 - Current
- Reviewed possible workers' compensation cases and obtained authorization to treat through insurance carrier information.
- Handled incoming calls from patients, employers, and insurance carriers to address inquiries and facilitate communication.
- Coordinated communication among health professionals and insurance carriers to ensure seamless patient care.
- Facilitated charge routing for accurate billing professional and hospital billing.
- Scheduled appointments for new injuries, follow-ups, DOT physicals, pre-employment services, and transfer of care.
- Co-led UBT monthly meetings to streamline workflows and improve the workplace environment for staff and patients.
Referral Coordinator
Los Angeles Orthopedics Sports Specialists
- Managed referral requests for multi-location LAOSS clinics, coordinating communication to meet deadlines.
- Submitted referrals to health plan HMO/PPO insurance carriers for billing, ensuring timely processing.
- Communicated with colleagues to ensure physician referral requests were accurately submitted before the deadline.
- Tracked referrals in Excel spreadsheets, maintaining accurate records for efficient follow-up.
Specialty Coordinator
USHW
- Coordinated preoperative exams, surgical procedures, and patient appointments.
- Coordinated patient load and schedules across multiple locations for USHW specialist providers
- Communicated with medical professionals and vendors to facilitate quality patient care.
- Completed work assignments to consistently meet aggressive daily deadlines.
Physicals Coordinator
USHW
- Reported physical and drug test results to employer contacts, ensuring timely and accurate communication.
- Updated clients daily on status of services rendered, fostering transparent relationships.
- Reviewed and analyzed medical case and employer instructions for accuracy, ensuring compliance with client needs.
- Conducted drug screenings and breath alcohol tests in compliance with regulations.
Patient Registrar
USHW
- Collaborated with clinical team to address patient needs and enhance customer satisfaction.
- Received, screened, and routed incoming calls efficiently to appropriate departments.
- Performed clerical duties including typing, filing, and scheduling appointments to support overall office operations.
- Provided resolutions to customer concerns.
Education
Graduate Certificate - MRI Technologist
National Polytechnic College
Lakewood, CA10-2026
Associate of Arts - Science & Mathematics
Rio Hondo College
Whittier, CA05-2026
Associate of Arts - Social Behavior & Self Developement
Rio Hondo College
Whittier, CA05-2023
Skills
- Proficient in Kaiser programs
- Health Connect proficiency
- Proficient in Excel
- Proficient in Microsoft Office Suite
- Workflow Optimization
- Process Improvement
- Customer service expertise
- Team Collaboration
- Cross-functional collaboration
- Independent and team collaboration
- Attention to detail
- Stress management
- Dependable
- Interpersonal communication
- Professional and strong work ethic
- Bilingual
WORK HISTORY
- Kaiser Permanente- Worker's Comp Processor I City of Industry, CA 2020-Present
- Los Angeles Orthopedic Sports Specialists- Referral Coordinator Pico Rivera, CA 2020-2022
- Kaiser Permanente- Worker's Comp Processor I Anaheim, CA 2018-2020
- Kaiser Permanente-Worker's Comp Processor I Santa Ana, CA 2017-2018
- Kaiser Permanente-Worker's Comp Processor I Irvine, CA 2017-2017
- U.S. HealthWorks- Specialty Coordinator El Monte, CA 2016-2017
- U.S. HealthWorks- Physicals Coordinator El Monte, CA 2015-2016
- U.S. HealthWorks- Patient Registrar El Monte, CA 2015-2016
Timeline
Worker's Comp Processor I
Kaiser Permanente
05.2017 - Current
Referral Coordinator
Los Angeles Orthopedics Sports Specialists
Specialty Coordinator
USHW
Physicals Coordinator
USHW
Patient Registrar
USHW
Graduate Certificate - MRI Technologist
National Polytechnic College
Associate of Arts - Science & Mathematics
Rio Hondo College
Associate of Arts - Social Behavior & Self Developement
Rio Hondo College