LINA SANTILLAN

Fontana, CA ***** ad20kx@r.postjobfree.com 909-***-****

PROFESSIONAL SUMMARY

● More than 20 years serving as an administrative/customer service professional in the healthcare field

● Advanced knowledge in HMO’s, Medicare, and Medi-Cal health plans specific to billing and scheduling.

● Energetic and self-motivated with a proven ability to multi-task in fast-paced environments.

● Superior communication skills that facilitate positive and collaborative working relationships.

● Ability to work independently as well as in a team based on the needs of the organization.

● Computer literate and adapt to new systems quickly. 60-65 wpm. PROFESSIONAL EXPERIENCE AND ACCOMPLISHMENTS

07/2015 – 12/2020 Grievance Coordinator

IEHP, Rancho Cucamonga, CA

● Interpret and apply complex policies and procedures regarding health plan grievances.

● Respond to customer inquiries regarding grievance process.

● Coordinate, document and track all grievances.

● Ensure grievance letters are sent within regulatory guidelines.

● Assist teammates with filing, tracking, and closing grievances.

● Liaise between internal departments to close grievances within regulatory deadlines.

● Maintain and prepare grievances summary reports.

● Ensure compliance with grievance resolution in accordance with all health plan regulatory agencies.

● Generate written correspondence to providers, members, and regulatory entities.

● Ensure the privacy and security of Protected Health Information (PHI). 03/2010 – 07/2015 Centralized Scheduler

Loma Linda Shared Services, San Bernardino, CA

● Respond to customer inquiries and deliver service within service level agreements.

● Schedule patient appointments and register customers for campus health classes.

● Responsible for canceling and rescheduling patient appointments.

● Verify, approve demographic and insurance data.

● Provide patient and physician referral assistance.

● Provide public access to information/services.

● Report preparation and generation.

● Clerical duties e.g., data entry, 10-key, fax, file. 01/2007 - 03/2010 Call Center Representative

Loma Linda Orthopedics, Loma Linda, CA

● Respond to customer inquiries and deliver service within service level agreements.

● Schedule, cancel and reschedule patient appointments.

● Verify, enter, and approve demographic and insurance data.

● Provided patient and physician with referral assistance.

● Check-in and check-out patients.

● Assist and train new employees.

● Report preparation and generation.

● Clerical duties e.g., data entry, 10-key, fax, file. LINA SANTILLAN PAGE 2

03/2005 - 01/2007 Access Center Counselor

Loma Linda University Health Care, San Bernardino, CA

● Respond to customer inquiries and deliver service within service level agreements.

● Schedule, cancel and reschedule patient appointments.

● Provide public access to information and services.

● Provide patient and physician referral assistance.

● Report preparation and generation.

● Clerical duties e.g., data entry, 10-key.

07/2003 - 03/2005 Insurance Verification Representative Loma Linda University Health Care, Loma Linda, CA

● Respond to customer inquiries and deliver service within service level agreements.

● Assist with calculating billing and insurance inquiries to provide patients with payment expectations.

● Answer and distribute incoming calls.

● Schedule, cancel and reschedule patient appointments.

● Distribute incoming mail, monitor, and prepare forms utilized in the department.

● Manage and prepare department productivity reports.

● Keep policy and procedure manuals current.

● Edit patient records.

● Clerical duties e.g., data entry, 10-key, fax, file. EDUCATION 1998 - 2004

San Bernardino Valley College, San Bernardino, CA 1998-2004 Certificate: Office Information System

American Red Cross, San Bernardino, CA

Certificate: CPR 2019-2021

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