Rebeca P Cruz

443-***-****

*** *** ****** **

Glen Burnie, MD 21061

ad4w92@r.postjobfree.com

Objective: To receive a challenging position with a growing company where my dedication and attention to detail will create opportunities for growth. I am conscientious, resourceful, flexible, and committed to producing results. I possess a solid base of knowledge and experience that will assist employers in meeting their goals and objectives. I have great interpersonal skills and I am detail oriented.

Education Detroit MI 2009

• High School Diploma

Cemprotec Dominican Republic

2005-2006

• Computer Science

Baltimore City Community Collage Baltimore MD

2010-2012

• Spoken Communications

Work Experience:

JMS Direct Inc.: Baltimore MD 2009-2011

Administrator.

• Make quality control calls

• Book people for interview

• Send emails

• Operated copy and fax machine

• Provide front desk coverage; make copies as deemed necessary and other duties as assigned.

• Answering phones

• Maintained up to date all the record of complete work Chase Brexton Health Care: Baltimore MD 2011-2017

Bilingual Call Center Representative.

• Answer telephone promptly and in polite and professional manner

• Obtain and enter accurate demographic information into Allscripts

(Address, Telephones Number, Insurance Information)

• Schedule appointment correctly- review appointment date, time location, and provider name with caller

• Inform caller of items to bring to appointment (including insurance card, medications, office visit fee, and verification of income - if applicable).

• Remind caller to arrive 15 to 30 minutes before scheduled appointment to complete paperwork.

• Remind caller of cancellation/no-show policy.

• Answer questions and offer other information, as requested, to provide patient-focused service and a positive impression of the organization

• Make reminder calls as requested...

• Make calls to reschedule appointments when necessary.

• Other reasonably related duties as assigned by supervisor or manager Chase Brexton Health Care

Care Coordination Navigator

Chase Brexton Health Care

• Communicates clearly with all members of the care team within the organization to convey pertinent patient issues, appointment information, provider schedules, and other information

• Creates flags and alerts in the medical record indicating quality metrics for which patients are due, and remove flags and alerts as needed

• Accurately documents medical data

• Consistently assists other members of patient care team

• Coordinates continuity of patient care with external healthcare organizations and facilities, including hospital admission and discharge and referrals from the primary care provider to a specialty care provider

• Understands and markets various services and programs to clients, based on case-by- case interviews and individual circumstances

• Responds to patient inquiries in a timely, courteous, and efficient manner

• Performs data entry and creates reports on tracked patients

• Compiles summary information periodically to ensure data collection and referral procedures are effective

• Ensures that all established patients have updated demographic information in the system

Patient Service Representative.

• Answers telephone and responds to inquiry, directs caller to appropriate area, or initiates triage slip for medical personnel response.

• Accurately schedules appointments.

• Works walk in patients into schedule

• Processes and tracks referrals in a timely manner.

• Greets and directs patients, salespeople, and visitors with courtesy and discretion, providing exemplary customer service.

• Registers patients and verifies that patient's record is up to date and accurate. Enters appropriate changes in CPS.

• Accurately enters confidential personal health information and financial information into CPS. Verifies insurance information,

• Detects and corrects errors, completes forms, obtains needed information and maintains logs and files.

• Complies with federal and local patient privacy laws.

• Collects and applies patient payments, adjustments, and reconciles daily cash reports.

• Manages files, initiates and replies to record requests photocopies records and documents for billing and/or legal services; sends and receives information via facsimile machine or email, complying with all laws pertaining to medical records. Effectively manages calls and deals with patient requests and complaints.

• Performs fee scale functions.

• Assists in coverage for other areas.

• Performs other tasks as needed under the direction of the lead PSR and/ or Director of Operations.

HealthCare Access Maryland Columbia, MD

2017-2022

Certified Bilingual Navigator

• Participate in training and successfully pass certification to be a Certified Navigator

(required for continued employment)

• Participate in continuing education training sessions and certification maintenance

• Understand eligibility requirements for Medicaid programs and Qualified Health Plans

(QHPs) and enroll consumers into appropriate coverage

• Work directly with clients face-to-face, over the phone, or via email to resolve enrollment questions and concerns

• Distribute information about the individual health insurance exchange, including eligibility requirements for applicable federal premium subsidies, cost sharing assistance and state medical assistance

• Provide information about Medicaid Managed Care Organizations (MCOs)

• Assist consumers with application, enrollment, renewal, and special enrollment period processes for QHPs

• Provide information on participating insurance carriers and plans in the marketplace and assist consumers with plan selection

• Understand insurance terminology and educate consumers on health insurance literacy

• Provide information to clients about verifications, document submission and applicable deadlines

• Provide referrals to appropriate agencies, including the Attorney General’s Health Education and Advocacy Unit (HEAU) and the Maryland Insurance Administration

(MIA), for applicants and enrollees with grievances, complaints, questions or the need for other social services

• Provide all information and services in a manner that is culturally and linguistically appropriate and ensures accessibility for individuals with disabilities or impairments

• Assists Limited English Proficient consumers in their native language, when the consumers prefer

• Participate in enrollment and outreach events

• Administrative duties related to documenting consumer information and data collection

• Escalate cases to Team Lead or Training and Quality Assurance specialists when appropriate

• Work closely with HCAM’s other programs to ensure comprehensive services to all consumers

• As assigned, answer calls and address consumer questions at the HCAM Call Center

• Other Duties as Assigned

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