Sandra Meneses

Riverside, CA *****

adx7lt@r.postjobfree.com

+1-951-***-****

An experienced Medical Assistant/UM Coordinator seeking for a reputable medical facility position where I am able to continue to develop and enhance my hands-on skill and knowledge in the medical field.

Authorized to work in the US for any employer

Work Experience

Referral Coordinator-Temp

Prospect Medical Group - Wildomar, CA

February 2023 to Present

• Process referrals for all line of business through IDX.

• Answer inbound calls and process phone STAT referrals.

• Call providers and Patients to notify of urgent approvals.

• Complete Cerecons comments providers submit for modifications

• Complete report daily to stay within compliance . Authorization Specialist

The KPC Group of Companies - Santa Ana, CA

August 2022 to February 2023

• Obtain census with patients that have discharged to verify/confirm inpatient authorization.

• Call insurances to obtain correct authorization number and status.

• Make sure all inpatient authorizations have the correct admit and discharge date.

• Make sure insurance has obtained all clinical, and discharge summaries.

• Input all inpatient authorization into paragon.

• Process inpatient authorization weather approved or denied.

• Check for authorization approval on all insurance web portals.

• Track all denials weather denied as not medically necessary or IP criteria not met. Patient Advocate

Corona Regional Medical Center - Corona, CA

May 2022 to July 2022

• Run census report for In House patients

• Screen uninsured patients

• Check eligibility

• Verify insurance Aid codes

• Review all patient documentation for medi-cal eligibility

• Work in a timely matter

• Guide patient with medí-cal application

• Covered California Certified

Patient Service Representative

Neighborhood Healthcare - Temecula, CA

August 2017 to March 2020

• Scheduling patient appointments.

• Verifying Insurance before patient arrival to make sure they are assigned to out office and to ensure benefits such as co-pays.

• Scrubbing charts days before.

• Calling HP to help patients make PCP changes.

• Answering phone calls.

• Daily report for patient insurance.

• Process F-pact, CHDP, and EWC programs.

• Calling patient insurance before patient appointment to make sure we obtain authorizations for acupuncture, mental health, and chiropractic services. Referral Coordinator

Coast Healthcare Management - Cypress, CA

October 2015 to July 2017

• Authorization Processing

• Eligibility Verification

• DOFR Verification to Enquire Financial Responsibility

• UM Daily Compliance Report

• Deal With Medi-Cal, Medicare, HMO, Medi-Medi, Most LOB Referral Coordinator

Accountable Healthcare Staffing

June 2014 to October 2015

• Process authorization through E-Health System such as Urgent, Routines, and Directs, check eligibility through member’s health plan to inquire if member is eligible before processing authorization.

• Prepare UM daily compliance report to make sure everything is within timeframe.

• Identify non contracted providers and request agreements when necessary.

• Check DOFR to enquire financial responsibility.

• Deal With Medi-Cal, Medicare, HMO, Medi-Medi, Most LOB Referral Coordinator

Healthsmart MSO - Cypress, CA

June 2012 to June 2014

• Responsible for the drafting of denial, modification, and delay letters and making sure that PCP and Specialist receive them via fax. Maintaining an order and log them in excel.

• Monthly report on denials for every health plan and line of business. • Running reports on excel for termed providers.

• Processing direct/routine/urgent authorizations. Medical Assistant

Pediatria Healthcare for Kids - Compton, CA

April 2010 to June 2012

• Was responsible for Front and back office ditties like registering patients, measuring vital signs such as temperature, pulse rate, weight, height, blood pressure and explaining clinic admission procedure to the patients and completing a full physical exam. Applied patient with vaccination needed. Verified patients eligibility and scheduled appointments. Education

High school or equivalent

Sunnyside High School

Medical Assistant Certificate

UEI College

Skills

• Healthcare (10+ years)

• Customer Service (10+ years)

• Communications (10+ years)

• Administrative Skills (10+ years)

• Utilization Management

• Insurance Verification

• EMR Systems

• Medical Records

• Experience Administering Injections

• Medical Office Experience

• Medical Scheduling

• Patient Care

• Bilingual

• Data entry

• Spanish

• English

• Hospital Experience

• Anatomy Knowledge

• Vital Signs

• Word processing

• Microsoft Excel

• Computer skills

• Microsoft Powerpoint

• Microsoft Outlook

• Medical terminology

• Communication skills

• Microsoft Office

• Organizational skills

• Microsoft Word

• Medical receptionist

• Intake

• HIPAA

• Office experience

• Typing

• Computer literacy

• Front desk

• Time management

• Phone etiquette

• Administrative experience

• IDX EMR System (1 year)

• Epic

• Clerical Experience

• Phlebotomy

Languages

• Spanish - Fluent

Certifications and Licenses

Medical Assistant

Present

HIPAA

Present

CPR Certification

February 2023 to February 2025

Heart saver CPR and AED

Assessments

Protecting patient privacy — Proficient

May 2022

Understanding privacy rules and regulations associated with patient records Full results: Proficient

Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.

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