Roberta Mendoza
San Ysidro California
Summary
Dynamic Case Manager with a proven track record at San Ysidro Health, experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, ensuring high standards, and aligning efforts with organizational goals. Known for collaborative approach and commitment to excellence.
Overview
21
21
years of professional experience
Work History
CDP Case Manager
San Ysidro Health
08.2019 - Current
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Patient enrollment into EWC and BCCTP programs for Cancer screenings or treatment.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Assigned and entrusted on training new personnel for Case Management. Provided leadership, guidance and support to staff members.
- Developed and implemented new strategies to improve work flow. Reducing processing time and increasing efficiency.
- Active participation in educational programs, current literature, in-service meetings and workshops. Such as weekly Leaders huddles and CQI meetings.
- Maintaining Clinic Productivity percentage on satisfactory levels.
- Increasing productivity by working Excel Data list for yearly follow ups.
Referrals Specialist
San Ysidro Health
02.2015 - 07.2019
- Called insurance companies to get precertification and other benefits information on behalf of patients.Obtained prior authorization for need procedures.
- Collaborated with healthcare providers to ensure accurate and complete referral information, improving patient care coordination.
- Streamlined referral processes for increased efficiency, resulting in timely appointments for patients.
- Verified Medical and Commercial insurance benefits and eligibility for Referral procedures before referring clients.
- Built professional relationships with Specialist and Medication Representatives.
- Scheduled appointments with specialists on behalf of clients.
- Obtained prior authorization for need procedures.
- Entrusted of training new Referral Specialists for processing an ethics.
- Selected to be part of the Emergency Preparedness Team Functioning as floor warden.
Batcher
Practice Development Strategies
03.2014 - 12.2014
- Prepared CMS 1500 form for proper billing.
- Responsible for courier bags and processed content with speed, precision and high degree of organization.
- Prepared tape total and deposit slips with 100% accuracy, tracked and logged deposits.
- Review supper bills prior to scanning and ensured copays are clearly recorded, corresponding cash, check, or credit card payments was present and balanced to any existing office batch summaries.
- Preparing paper claims by gathering proper information as authorization, progress notes, surgical notes etc.
Medical Office Assistant Supervisor
Marcos Borrero, M. D. Inc.
06.2004 - 02.2013
- Accurately verified Medical Insurance eligibility, medical coverage, IPA, PCP, for billing purposes.
- In charge of coordinated patient scheduling, check-in, check-out and payments for a high volume General Practice medical clinic setting including five PCP's and two Specialists.
- Updated patient information and insurance details for accurate electronic medical records.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Balancing and making multiple bank deposits of daily copayment and deductibles.
- Entrusted with practice keys and Personnel Training.
Education
Associates- Not Completed - Women's Studies
SWC
Chuls Vista, California01-2026
Certifcate - Medial Office Administrator
US Collegues
San Diego09-2014
CA Certified MA Admin/Clinic - Administrative And Clinical
California MA Certification Board
Chula Vista, California10-2008
Certificate - Insurance Billing And Coding
Regional Occupationa Program
Chula Vista, California03-2008
Medical Assistant Clinical -
Regional Occupational Program
Chula Vista CAlifornia06-2007
MA -
Medical Office Assistant Billingual
Southwestern College06-2005
Interpreter -
Interpretation Skills
Vista Community Clinic04-2004
Skills
- Problem-solving
- Case management
- Time management
- Case documentation
- Relationship building
- Conflict resolution
Languages
Spanish
Bilingual or Proficient (C2)
Additional Information
ASL- American Sign Language Basic
Timeline
CDP Case Manager
San Ysidro Health
08.2019 - Current
Referrals Specialist
San Ysidro Health
02.2015 - 07.2019
Batcher
Practice Development Strategies
03.2014 - 12.2014
Medical Office Assistant Supervisor
Marcos Borrero, M. D. Inc.
06.2004 - 02.2013
Associates- Not Completed - Women's Studies
SWC
Certifcate - Medial Office Administrator
US Collegues
CA Certified MA Admin/Clinic - Administrative And Clinical
California MA Certification Board
Certificate - Insurance Billing And Coding
Regional Occupationa Program
Medical Assistant Clinical -
Regional Occupational Program
MA -
Medical Office Assistant Billingual
Interpreter -
Interpretation Skills
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