Keops Amir Oliver García

• Developed strong rapport-building skills through daily interactions with diverse clients over the phone
• Acted as the first contact point to help our members set up appointments as per their needs.
• Perform Health Risk Preventive Services such as Medication Reviewings, among others.
• Enhanced customer relationships through timely and professional follow-ups with active members
• Interpret from native English speakers (doctors & providers) to Spanish-speaking members and vice versa.
• Responsible for coordinating added value services such as laboratory works, lodging, transportation, among other benefits, on the members´ behalf
• In charge of documenting and processing medical reimbursements and applications to different medical programs based on eligibility, to safeguard our clients´ policies.
• Assigned to carry out research to fulfill medical policies and help solve members´ grievances
• In charge of: consulting/activating/deactivating balances on medical cards
• Helped Members with their Billings and Reimbursements.
• Helped members to configure their electronic accounts within their portals and their mobile applications.
• Performed follow-up calls with potential customers to regain their interest in scheduling new preventive appointments to help our vendors and our providers increase the volume of their medical appointments.
• Explained detailed medical procedures prior to their appointments to help members overcome fear, stress, and cancellation endings.
• Help members calculate fees regarding their upcoming services.
• Promote the use of the in-network services.
• Educated members on how to use digital applications (Store item scanners, medical apps, telehealth mobile apps, among others)
• Coordinated purchases with providers, sent materials, and made deliveries of pharmaceuticals and durable medical equipment.
• Provided members with information regarding our different plan options and taught them how to apply for them.

EXPERIENCE IN MEDICAL RECORDS COORDINATION.

• Requested Initiation: Initiate, track, and follow up on requests for medical records from external physicians, hospitals, and diagnostic centers.
• Release of Information experience (ROI): Preparing, verifying, and sending valid patient authorization forms (ROI) to external facilities to legally obtain records.
• Tracking and Follow-Up: By monitoring the status of pending record requests, sending follow-up requests if records were not received within established timelines.
• Experience with data Integration/Importing: by receiving incoming records (via fax, mail, electronic transfers).
• Data Management: by compiling, verifying, and filing patient medical records (paper and electronic), ensuring accuracy and completeness.
• Quality & Completeness Review: Reviewed incoming records to ensure completeness and accuracy compared to the initial request. Thoroughly reviewed the obtained records and created a summary with the relevant information for internal and external purposes. Shared the obtained records and outstanding remarks with the corresponding clinic.
• Confidentiality & Compliance: Ensured all records comply with HIPAA regulations.