Healthcare Operations & Claims Professional | Case Management | Member Services | Insurance & Benefits | Bilingual English/Spanish
Experienced healthcare professional with 7+ years of experience in healthcare operations, member and patient services, insurance benefits, claims, case management, and appeals. Skilled in reviewing and analyzing complex healthcare information, resolving issues, coordinating services, communicating with providers and members, and ensuring compliance with policies and regulations. Experienced in preparing position statements and supporting documentation for appeal hearings, managing sensitive and confidential information, and delivering high-quality customer service. Strong knowledge of medical and dental insurance, eligibility and benefits, claims processes, EHR systems, and HIPAA requirements. Bilingual in English and Spanish with strong communication, analytical, organizational, and problem-solving skills. Recognized for accuracy, professionalism, adaptability, and the ability to manage multiple priorities in fast-paced healthcare environments.
Member Since
September 1, 2026
Last Active
2 months ago