Cassandra Rodriguez
Tucson
Summary
Organized, hard-working professional looking for growth-oriented position. Skilled in customer service, problem solving and collaborating effectively with diverse teams. Successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
9
9
years of professional experience
Work History
Referral Specialist
Chenega Federal Solutions
02.2025 - Current
- Processes referrals for Behavioral Health, Specialty Care, Durable Medical Equipment, Inpatient Admissions, Military Treatment Facilities, and Urgent referral and authorization requests.
- Assesses electronic documents to ensure appropriate entry into the medical management system.
- Assesses tasks for authorization/referral request to ensure accurate entry into the medical management system.
- Identifies potential discrepancies in the medical management system to assure quality compliance.
- Ensures procedures are followed for referrals based on beneficiary eligibility type, geographical location, and on the provider's request.
Sunbelt Medical
02.2024 - Current
- Submits and monitors insurance claims
- Assisted with billing inquiries and provided timely responses to enhance customer satisfaction
- Researched and resolved billing discrepancies to enable accurate billing.
- Benefits review
- Perform in-depth account review such as; correspondence research, secondary claims billing, payment review, contractual adjustments, and modify insurances/demographic information is correct and in compliance with billing policies and procedures for appropriate next required action
Unit Coordinator II
The Crisis Response Center
04.2021 - Current
- Registers individuals for services, including verification of AHCCCS eligibility, collects appropriate authorizations and release of information documents
- Oversees episode of care in electronic health record with accuracy and efficiency
- Coordinates the discharge of patients with other inpatient facilities and within the electronic health records
- Obtains clinical records/documents as requested
- Communicates information to physicians, nurses and clinical team members
- Coordinates with other providers to assist with the discharge and/or transfers
- Coordinates bed placement for level 1 and 2 beds
- Achieved appropriate patient flow by admitting, transferring and discharging patients in computer system and notifying appropriate personnel of patient status verbally and through signage.
- Coordinated and maintained referral sources related to admissions, discharges and follow up services to sustain daily census requirements.
Advanced Claims Analyst
Centene
10.2019 - 02.2022
- Process pended medical claims, verify and update information on submitted and reviewing work
- Processes to determine reimbursement eligibility
- Ensure payments and or denials are made correctly
- Research and determine status of medical related claim
- Meets department production and quality standards.
Unit Coordinator
AZ, Crisis
12.2018 - 10.2019
- Registers individuals for services, including verification of AHCCCS eligibility, collects appropriate authorizations and release of information documents
- Oversees episode of care in electronic health record with accuracy and efficiency
- Coordinates the discharge of patients with other inpatient facilities and within the electronic health records
- Obtains clinical records/documents as requested
- Communicates information to physicians, nurses and clinical team members
- Coordinates with other providers to assist with the discharge and/or transfers
- Coordinates bed placement for level 1 and 2 beds.
Billing Specialist/Patient Accounts
United Community Health Center
07.2016 - 12.2018
- Submits and monitors insurance claims, posting payments, sending patient statements, completes daily reports, completes monthly report of payments received from insurances and patients from all clinics, assisting patients with claim concerns and questions.
- Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
- Researched and resolved billing discrepancies to enable accurate billing.
Education
Medical Billing and Coding
Carrington College
Tucson, AZGeneral Studies
Mountain View High School
Tucson, AZSkills
- Computer proficiency
- Problem-solving abilities
- Customer service skills
- Teamwork
- Multitasking
- Organizational skills
- Problem solving skills
- Computer Literacy:
- Excel, Access, Word
- PowerPoint
Timeline
Referral Specialist
Chenega Federal Solutions
02.2025 - Current
Sunbelt Medical
02.2024 - Current
Unit Coordinator II
The Crisis Response Center
04.2021 - Current
Advanced Claims Analyst
Centene
10.2019 - 02.2022
Unit Coordinator
AZ, Crisis
12.2018 - 10.2019
Billing Specialist/Patient Accounts
United Community Health Center
07.2016 - 12.2018
General Studies
Mountain View High School
Medical Billing and Coding
Carrington College
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