Experience

Health Care Partners Gardena

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Oncology Coordinator

  • May 2012 - Present

  Data entry of faxed referral request for initial/continuation treatment review for oncology and specialty drugs. Liaising with provider offices for clinical documentation for oncology and specialty drugs medical reviews. Assisting the Medical Director in obtaining additional clinical documentation etc. Occasionally setting up peer to peer calls for doctors. Maintaining and processing medical necessity, out of network and lack of information denials and updating records. Updating and maintaining clinical documentation.  Redirecting request from out of network physicians. Liaising with physician staff regarding urgent request as well as the determination of the request.  Notifying physicians office of rejected pharmaceutical prescription requests. Assist other departments with obtaining medical criteria, approval on pending referrals and also help with the work flow of the day Taking customer service calls which can include the correcting of physician requested modification on approvals Maintain clinical batching for turnaround times to keep referral request within contractual compliance  Notify members with regards to updates or modifications on requests. Show less

• Personal Care Coordinator

  • Sep 2008 - May 2012

  Calling members 65 yrs. and older to see how they are doing. Assist members is scheduling doctor appointments. Call providers offices to obtain referral request and clinical information for members upcoming appointments.Consult with the nurses or medical directors for review of clinical information submitted.  Provide approval letters for specialty appointments after review by the nurses or medical directors. Supply educational materials on health related topics. Help in finding doctors in the network in or around their neighborhood.  Refer calls to be assessed by our Priority Care Coordinator and or Social Worker. Assure that contact information for the members are up to date, and supply database manager with updated information via Access Database if available. Show less

• Receptionist

  • Apr 2008 - Sep 2008

  Answer a multiple phone line system, transfer calls to the appropriate department. Sign for Incoming mail from UPS & FedEx. Meet and greet members. Monitoring access to the office by employees in other departments.



Washington Mutal

• United States
• Financial Services
• 1 - 100 Employee

• Receptionist

  • Jul 2007 - Feb 2008

  Answered a multiple phone line system, determined the nature of the calls and directed callers to the appropriate department. Handled customer care queries using LTDB (Loan Tracking Database) for processing and or underwriting assistance.  Multi-tasking of responsibilities between processing and closing departments.  Sourcing loan conditions for processing using WAMU Broker website and then updating LTDB. Liaised with various brokers on a daily basis with regards to adverse loan status.  Daily update of Retention List spreadsheet for shipping logs on adverse files.  Receive and organize adverse files in date order for shipping to storage.  Receive organized and distributed all incoming mail from FedEx, UPS, DHL and USPS.  Daily liaison with front office customers and various departments and staff.  Maintained and received stationary supplies for 8 departments.  Prepared shipment labels for FedEx pick up daily. Show less