CRISTINA CONCEPCION-REMIGIO

Santa Clarita, CA ***87 818-***-**** adzz43@r.postjobfree.com

PATIENT CARE COORDINATOR

Dedicated Patient Care Coordinator offering in-depth knowledge of Business Management of Corporate Healthcare, Customer Service and Insurance. Adept in supporting various health plan branding and health groups. Collaborative professional skilled in resolving client concerns in a timely and effective manner.

AREAS OF EXPERTISE

HCPCS Coding Guidelines ICD-9 International Classification of Disease Systems Office Management

Medical Terminology Intake & Billing Medical Insurance Prior Authorization Benefit Eligibility

APPLICATIONS

Microsoft 365 MS 365 Teams MS Edge Internet Explorer Google CHROME (Reports) Skype for Business Vonage Mobile Connect Cisco AnyConnect Outlook 8x8 Communications Zoho: Mail, Docs, Creator, Calendar, Sheets

PROFESSIONAL EXPERIENCE

Quest Diagnostics, Santa Ana, CA April 2021-February 2023

Quest Health Connect (QHC) /Patient Care Coordinator I Extended Care (Business Unit)

Supported Outbound calls/Inbound calls (approx. 150 daily calls) /meeting goals of schedules made

Used multiple PC screens and daily work assignment sheets

Utilized appropriate soft skills and customer service skills to handle broad range of issues and escalated issues

Scheduled members under various services such as: DEXA (Osteoporosis), HRA-Health Assessment, DRE (Diabetic Retinopathy Screening), TeleHealth

Supported Various Health Plan Branding / Health Groups

Handled Member Cancellation process

Participated in team meetings and trainings

Documented details of tasks completed and maintain complete and accurate records of Member Profile/Notes

Reported client concerns using established protocols

Met or exceeded performance standards, attendance, and schedule adherence

RCR Management Services, Inc. (Live Answering Service), Glendale, CA October 2018-Present

Business Owner/ Management

Highly motivated Business Owner who is a great TEAM player and great contributor with extensive knowledge in healthcare and customer service

Oversaw the daily operations of the business

Managed marketing, bookkeeping, payroll, advertising

Metrics and Measures Management of Operations, Human Resources

Ability to manage multiple priorities at one time

Recruiting, Marketing, Training

Creating SOP

Tracking and Managing staff Timesheet and Payroll

Accounts Payable and Receivables

Call Reports to Clients

Client Account Management

Staffing and Scheduling

Contracting, Negotiating & Signing

Cigna Healthcare–Glendale CA May 2012-December 2013

Health Service Specialist

Investigated, provided and submitted information to Quality Department about special incidents, events and complaints

Assisted resolving issues and satisfying client requests and internal operational issues

Collaborated with department managers to correct problems and improve services

Partnered with management team to make necessary improvements and satisfy Management, Teammate and Patient needs

Cristina Concepcion-Remigio adzz43@r.postjobfree.com page two

Starwood Hotels & Resorts Worldwide, Inc.–Lancaster CA December 2006-March 2010

SPG Virtual Associate

Promoted the hotel brand's loyalty scheme through selling new Hotel & Resort special Member rates and deals

Performed Telephone and Email correspondence

Increased hotel revenue, profits and market share through up selling and brand loyalty and multiple reservations

Problem Solved Membership Account inquiries and Maintenance

Updated team members about changes in hotel products, services, pricing and policies

Processed Reservation of Hotels (including Luxury brands) and Resorts worldwide

WellPoint BlueCross of CA (aka Anthem)–Woodland Hills CA August 2002 to September 2005

Provider Care Associate (PCA I /II) Benefits & Eligibility/ Claims

Researches and analyzes data to address operational challenges and customer service issues

Analyzes problems and provides information solutions

Demonstrated ability to help motivate outstanding healthcare teammates

PCA I/II Benefit & Eligibility /Claims responds to Provider/Medical Groups inquiries, questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims.

Operates a PC/image station, multiple screens to obtain and extract information; documents information, activities and changes in the database

Thoroughly documents inquiry outcomes for accurate tracking and analysis/ perform follow-up telephone calls, E-mail to customer questions that are routine in nature

Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner

Provide knowledge of company services, products, insurance benefits, provider contracts and claims

Administer HIPAA Privacy and Security Rules to ensure compliance

ADDITIONAL RELEVANT EXPERIENCE

Northridge Hospital Medical Center (CHW Affiliate)–Human Resource Assistant

TrinityCare, L.L.C. (CHW Affiliate)–Medical Billing Clerk III/ Front Office Admin

Contact this candidate