Xitlalic Canchola
Norwalk,CA
Summary
Adept in healthcare and customer service, I excel in problem-solving and bilingual communication. At AltaMed, I significantly improved issue resolution times and participant satisfaction. My expertise in HIPAA compliance and appointment scheduling, coupled with a talent for empathetic interaction, positions me as a valuable team collaborator.
Overview
5
5
years of professional experience
Work History
Senior Care Advocate
AltaMed
06.2024 - Current
- Researched issues and took appropriate action to resolve issues within turnaround time requirements and quality standards.
- Documented activities and progress in electronic medical record per defined policy and procedures.
- Assisted in completing and maintaining current eligibility requirements with Medi-Cal. Assisted with completing Enrollment Agreements for Medicare.
- Contacted billing departments to assist the participants with their medical bills.
- Assisted participants with starting grievances and appeals process. Educated the participants on the process, and answered any questions or concerns.
Appointment Scheduler and Operator
Montes Medical Group
04.2023 - 06.2024
- Provided excellent customer service through attentive listening, empathetic communication, and efficient problem-solving during the scheduling process.
- Answered phone calls and answered questions from patients
- Managed high call volume while maintaining professionalism and accuracy when gathering client information for appointment bookings.
- Acted as first point of contact and set appointments for patients
- Triaged patients symptoms and sent messages to the on-call provider to assist with medical needs and concerns
Customer Service Representative
CalOptima
02.2020 - 04.2023
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving problems with Medi-Cal coverage
- Assisted members with starting grievance and appeals process.
- Handled escalated calls efficiently, finding satisfactory resolutions for members, or provided them with information as to who they need to speak with. Example: Social services, Social Security, CalFresh.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information. Example: Authorizations approvals or denials
- Maintained detailed records by thorough documentation.
- Assisted customers in navigating company website and assisting them find primary care, physicians or urgent cares contracted with their corresponding insurance
Education
Bachelors - Sociology
Cal State University Long Beach
Long Beach, CA05.2018
Skills
- Professional boundaries
- Self-awareness
- Cultural history
- Healthcare
- Customer service
- Problem-solving
- Bilingual- Spanish speaker
- Friendly and outgoing
- Multitasking and organization
- Team collaboration
- HIPAA compliance
- Verbal and written communication
- Flexible schedule
- Data entry
- Medical terminology
- Conflict resolution
- Appointment scheduling
- Eligibility determination
- Call screening
Timeline
Senior Care Advocate
AltaMed
06.2024 - Current
Appointment Scheduler and Operator
Montes Medical Group
04.2023 - 06.2024
Customer Service Representative
CalOptima
02.2020 - 04.2023
Bachelors - Sociology
Cal State University Long Beach
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