Patient Support Call Center
Resume:
Georgina Esparza
Seasoned healthcare professional with extensive experience in patient support and coordination. I excel at managing appointments, handling insurance details, and resolving patient issues with a friendly and efficient approach. Comfortable dealing with high volumes of calls and keeping accurate records. I’m great at connecting with patients and their families, ensuring they get the care and support they need. HIPAA certified and fluent in Spanish, I’m passionate about making a positive impact in healthcare.
Skills
Enhanced Care Management
Call Center Heavy Call Volume
HIPAA Certified
Results-Oriented
Operations Management
Quick Learner
Computer Proficient (Microsoft Office)
File/Records Maintenance
Report Generation and Analysis
Financial Records and Processing
Contract Negotiation/Review/Drafting
Contract Auditing
Training and Development
Change Management
Bilingual (Level 1 Spanish Speaking)
Lead Care Manager
Cardin Healthcare, Long Beach, CA
January 2024 – July 2024 (Laid off)
Worked under the ECM Program
Led a team in managing patient care plans and ensuring effective coordination between care providers.
Met with members often at different locations
Developed and implemented strategies to improve patient outcomes and streamline care processes.
Provided guidance and support to care managers and assisted with complex patient cases.
Enhanced communication with patients and their families to ensure clear understanding of care plans and procedures.
Patient Support
Optum Healthcare Torrance, CA
Patient Support
December 2019 – December 2022
Managed patient appointments, reviewed hospital discharge notes, and handled referrals.
Responsible for high call volume
Processed appeals, grievances, and verified patient insurance eligibility.
Updated systems as needed, researched and responded to patient needs, and handled high-volume calls.
Communicated with hospitals, case managers, and patients’ families regarding hospice and home healthcare.
Setting up care for specialty doctors
Claims Agent
Molina Healthcare, Long Beach, CA
December 2016 – June 2019
Managed member and provider calls, resolving and reviewing medical forms for billing.
Handled multi-million-dollar claims, reviewed contracts, and managed ICD-9, 1500, and UB04 forms.
Provided daily reviews and offered bilingual support (Spanish).
Front Office Coordinator
OMNE La Puente, CA
March 2012 – February 2015
Managed incoming/outgoing calls from employees and clients.
Coordinated travel to multiple states and handled hiring, payroll, and training for 1-100 employees.
Ensured employee safety and adherence to company protocols.
Chief Otho Secretary
Riverside County Hospital Eye Clinic Riverside, CA
May 2014 – August 2016
Provided onsite training and controlled the release of proprietary and confidential information.
Organized and coded documents related to due diligence for acquisitions.
Reviewed and commented on document adequacy, addressing deficiencies as necessary.
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