Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

Alma L Cordova

San Luis

Summary

Experienced Healthcare Coordinator, well proficient in handling clerical, non-clerical and case management in busy healthcare environments. Organized and detail-oriented with planning and communication skills. Ready to offer 15 years of related experience to a challenging new role with room for advancement.

Overview

9
9
years of professional experience

Work History

Clinical Administrative Coordinator

United Healthcare
10.2019 - Current
  • Provide comprehensive administrative support to RN and Medical Directors.
  • Review and approve prior authorization requests based on respective state directives.
  • Review cases to determine need for escalation, request clinicals and task for further review by RN or Medical Director.
  • Maintain high-level knowledge of state regulations for prior authorization processing.
  • Assist providers with answering questions and providing assistance with how to enter prior authorization requests in on-line portal and how uploading clinicals.
  • Contact providers via phone or fax to inform of determination for reviewed prior authorization..
  • Cancel and recreate prior authorization requests when submitted incorrectly.

Member Navigator

United Healthcare
03.2016 - 10.2019
  • Assisted team of Member Navigators by contacting members and schedule home visits for Navigators to provide education and assist with barriers to care.
  • Contacted members, by phone or in person, who have not yet been able to be reached by other programs within the company and assist in closing gaps in care.
  • Assessed members and address any barriers to care; such as housing, transportation, co-pays or access to a PCP.
  • If needed, referred members to other programs for assistance, such as local community programs.
  • Assisted member in making and keeping appointment with PCP and address all healthcare needs.
  • Copied, logged and/or scanned supporting documentation.
  • Self-directed with astute judgement skills.
  • Educated member on importance of closing gaps in care and reminded of treatment protocols (i.e. follow-up
    appointments, taking medications, diet)

Clinical Associate

Yuma Regional Medical Center
11.2014 - 03.2016
  • Perform vitals on patient ranging from newborn to the age of 21.
  • Assist patients/families with setting up transportation.
  • Complete Welcome Call. (i.e. contact families, provide education on CRS program, conduct a brief Social and
    medical history interview and gather medical records as necessary.)
  • Remind patient/families of future appointment and conduct appointment confirmations.
  • Assist with English/Spanish interpretation when needed.

Education

MA (Accreditation) -

American Association For Medical Assistants
Yuma, AZ
2016

CNA Certification -

Arizona Western College
Yuma, AZ
05.2006

Spanish Interpreting For Medical Personnel -

Yuma Regional Medical Center
Yuma, AZ
2006

Medical Terminology -

Yuma Regional Medical Center
Yuma, AZ
2004

High School Diploma -

Kofa High School
Yuma
05.2002

Skills

  • Patient Services Management
  • Computer Proficient
  • Filing System Experienced
  • Time management
  • HIPAA Compliant
  • Team player
  • Strong interpersonal skills
  • Quick hands-on learner
  • 40 wpm
  • Works well under pressure

References

Available upon requests.

Timeline

Clinical Administrative Coordinator

United Healthcare
10.2019 - Current

Member Navigator

United Healthcare
03.2016 - 10.2019

Clinical Associate

Yuma Regional Medical Center
11.2014 - 03.2016

MA (Accreditation) -

American Association For Medical Assistants

CNA Certification -

Arizona Western College

Spanish Interpreting For Medical Personnel -

Yuma Regional Medical Center

Medical Terminology -

Yuma Regional Medical Center

High School Diploma -

Kofa High School

Similar Profiles

CREATE PROFILE
Alma L Cordova