Referral Specialist Eligibility
Resume:
Nelida
Quiles
York, PA *****
**********@*****.**
I have been With Family First Health for 18 years and I started as a social worker for the Healthy York Network when the program just started. And was offered the Referral position after I completed my year with the temp agency. I have enjoyed every moment, challenge, anything that was going to help our patients and community. I've also volunteered my services for any of our school base events. I am always looking for more when it comes to Family First Health. I strive for more. I love my community .my patients and co-workers. Every bit of my experience is utilized at Family First Health and I want to continue to be helpful for everyone. Help keep medical office operations smooth and efficient by organizing files, scheduling appointments and assisting patients. Background includes working in a busy and cultural settings to handle all provider and patient needs. Good interpersonal and communication skills. Well-organized with demonstrated knowledge of healthcare procedures and environments. Experienced with insurance forms, charts and other business correspondence. Successful bilingual person to better serve local immigrant population and our community Proactive fluent in Spanish language and offering a background in Passionate and a team member successful working with patients and provider, building positive experiences. Well-rounded professional highly skilled at handling patient issues and answering questions. Team player. Enthusiastic and offering 18 years of experience in communicating positively with physicians, office staff, and patients. Polished, hard worker and willing to go extra mile to complete any task. Established Medical Receptionist successful at interacting with people of all ages and personalities and offering experience working in busy clinical settings. Bringing a successful career history Experience supporting physicians in busy medical office. Expertise includes verifying insurance coverage, records reviews and schedule maintenance. Forward-thinking and friendly with distinguished ability to multitask, modernize offices and streamline procedures. Fantastic attention to detail and commitment to optimizing patient experiences through individualized care. Skilled in managing diverse medical needs in high-volume, patient-centered settings. Proficient in coordinating charts, collecting payments and managing forms. Highly organized and resourceful with excellent judgment and multitasking abilities. Patient Registration with administrative expertise and 20 years of experience in healthcare office. Competent in using Athena for patient scheduling and information management. Demonstrated,history of facilitating patient flow through excellent organization and communication skills.
This Pandemic has opened us up to new experiences, as to how we can still take care of our patients and community. We have Videohealth for the high risk patients that we do not need to bring into the office. And Telehealth, we can call the patients and do phone visits.We are here to serve,to guide,to help anyone in so many different ways and with our resources that we have and many more... Work
Experience
Medical Reception
Family First Health
March 2014 to present
Family First Health, Medical
Receptionist March 2014 - present
• Secured, organized and updated physicians and referral/insurance documentation
• Gathered information to file for authorization denials and minimized inaccuracies by maintaining accurate records of approvals
• Supervised and trained nursing staff on referrals to specialist
• Created and maintained accurate and confidential patient files
• Scheduled and confirmed patient appointments for diagnostic, surgical and consultation services in busy specialist offices within 1 week
• Contacted other medical facilities to confirm
medical histories
• Addressed, documented, and responded to incoming and outgoing calls and correspondence
• Called patients to schedule appointments, consistently double-checking information and availability
• Updated group medical records and library to support smooth office operations
• Worked with our providers to prepare out going referrals for over 50 daily referral appointments
• Answered over 60 average daily phone calls to schedule appointments and address patient inquiries
• Updated patient financial information to ensure
accuracy
Referral Specialist
Family First Health -
York, PA March 2005 to
March 2014
Family First Health, Referral
Specialist March 2005
• Secured, organized and updated physicians and referral/insurance documentation
• Gathered information to file for authorization denials and minimized inaccuracies by maintaining accurate records of approvals
• Supervised and trained nursing staff on referrals to specialist
• Created and maintained accurate and confidential patient files
• Scheduled and confirmed patient appointments for diagnostic, surgical and consultation services in busy specialist offices within 1 week
• Contacted other medical facilities to confirm
medical histories
• Addressed, documented, and responded to incoming and outgoing calls and correspondence
• Called patients to schedule appointments, consistently double-checking information and availability
• Updated group medical records and library to support smooth office operations
• Worked with our providers to prepare out going referrals for over 50 daily referral appointments
• Answered over 60 average daily phone calls to schedule appointments and address patient inquiries
• Updated patient financial information to ensure
accuracy
Eligibility Specialist for Caring together Ryan White Program Family First Health July 2019
• I help patients apply for medical
assistance MAWD.
• I help patients apply for special pharmaceuticals benefit programs.
• I help patients apply for health care network
programs.
• Social security income applications and
resources.
• Certify the patients for the caring
together program.
• Work closely with medical insurance
companies.
• I work with patients from our site and York hospital community center.
Family First Health
415 E.Boundary Ave and other locations
Medical Reception
July 2019 - Present
Scheduling and cancelling appointments
Transferring calls
Sending patient’s messages to their PCP and team members Checkin and Checkout
Telehealth and Videohealth
Training our patients on how to use videohealth
Insurance Eligibility
Covid Screening
Answering phones
Working side by side with the provider
Provider assignments
Community Resources as needed
Education
New Utrecht High
School but did not
complete
Skills
• Medical
terminology
•
Outpatient
• Outpatient
care
•
Charting
•
Bilingual
• Front
Desk
• Front
Office
•Athena
Computer
knowledge
Additional
Information
SKILL
S
•
Self-discipli
ne
• Speaking
clearly
• Culturally
sensitive
•
Charting
• Personal and professional
integrity
• Computerized
charting
• Maintaining
records
• Inpatient and
outpatient care
• Practiced inpatient and outpatient
caregiver
• Medical terminology
knowledge
•
Bilingua
l
•
Resources
Contact this candidate