Sandra Alcocer

adwjhj@r.postjobfree.com

956-***-****

**** * **** *****, ********, TX. 78541

SKILLS

• Bilingual in English and Spanish

• 23+ years within the healthcare field

• Proficient with ICD and CPT coding

• Knowledgeable with Medicare, Medicaid, and commercial insurance

• Experience with multiple phone line system

• Costumer care

• Proficient in PowerWorks

• Data Entry

• Experience with scanner, fax and copier machine

• Proficient in TruCare

• ABD Calculators

• Amisys

• OMNI

PROFESSIONAL EXPERIENCE

HealthCare Support Staffing / CENTENE Corporation 11/14/2022 - 04/03/2024

Customer Service Representative I

Received inbound calls for Ambetter Marketplace Costumers Help Costumers with explanation of benefits

Locate Providers and Pharmacies for Costumer Services Take Premium payments over the phone

Enter information into system, update any demographics changes in members accounts Update PCP’s information for costumers

Connect members to different services as needed (Pharmacy, Claims, Authorization, Marketplace, etc.) Superior Health Plan (CENTENE Co.)

Program Coordinator I (CAT- Centralize Authorizations Team) 12/17/2018 – 03/31/2021

. Create authorizations for Waver and Non-Waiver members for the following services: Personal Assistance Services, Emergency Respond System, Home Delivery Meals, Respite and DAHS also Authorization Closures when needed.

- Verify Benefits and eligibility

- Confirm PSON, MN Letters and 2056D approvals when required.

- Coordinate services with community base organizations on referrals for new members.

- Calculated units for services according to ISP year, increases and members with new assessments.

- Create and fax authorization letters with respective notes and attached fax confirmations.

- Screen and identify members by priority for case management assessments.

- Attend routine meetings, trainings and the planning of special projects for the team and the company such as contributions for United Way, birthdays and special holydays or e events. HealthCare Support Staffing / Superior Health Plan (CENTENE Co) 09/6/2017 – 12/14/2018 Program Coordinator I

. Contact doctors’ office and clinics to obtain providers signatures for MN Signature Forms for members enrolled in the Waver Program

. Assign the MN Signature Request tasks for a group of Program Coordinators to complete.

. Assign MN Signature Approved tasks to Service Coordinators to complete.

. Contact members in Waver Program with updates and information.

. Familiar with MNLOC, PSON and MN Signature Forms

. Create and assign new tasks when required

McAllen Surgeons, L.L.P

Office Specialist / Insurance Clerk 12/2006 – 09/2017

• Insurance authorizations for full admit or outpatient surgeries, workers compensation claims and approvals, Veteran Administration (VA) appointments and approvals

• Answer phones, log calls and messages into the computer system and e-mail to clinical and office staff

• Schedule appointment for new patients and follow-up visits.

• Scan records, patient’s information and reports into computer system

• Data entry

• Verify coverage for all type of insurances, and collect co-pays, payments, deductibles and made payment arrangements for private pay patients

• Give directions and instructions to patients scheduled for surgery

• Log payments and deposit slip

McAllen Surgeons, L.L.P

Front Office Supervisor: 06/2003 – 12/2006

• Manage the front desk and reception area, including greeting patients and visitors

• Maintained front desk and reception area in a neat and organized fashion.

• Obtained authorizations and verified Medicare, Medicaid, and all other Insurances coverage for surgeries

• Answered telephones and direct calls to appropriate staff

• Collected payments and deductibles for surgeries

• Mailed out patients records for medical disability and DARS

• Obtained approvals and authorizations for Workers Compensation

• Supported management and handled extra projects as needed

• Fixed doctor’s schedule for office visits

• Hired and trained new receptionists

McAllen Surgeons, L.L.P

Receptionist: 12/1999 – 06/2003

• Answered multiple telephone lines

• Made appointments for new patients and follow-up visits

• Received and posted payments, deductibles and charges

• Confirmed appointments and rescheduled patients when needed

• Filed patients charts and medical records in charts

• Faxed reports and records for referrals

• Greeted patients and visitors as they came to the office for doctor's visits or meeting

• Pulled out charts for scheduled clinics

• Give out orders and instructions for surgeries

EDUCATION

General Education Diploma

Youth Fair Chance

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