Mimi Ortiz
Evans
Summary
Achieved high levels of customer satisfaction through proactive service and support. Improved operational efficiency by effectively managing time. Developed innovative solutions by identifying and addressing emerging trends.
Overview
14
14
years of professional experience
Work History
Home Health Aide
The Ridge Senior Living Facility
01.2020 - 04.2022
- Assisted clients with activities of daily living bathing, dressing and other routine self-care activities, medication reminders. Escort to and from meals. Helped clients move in and out of beds, baths and wheelchairs.
- Collaborated closely with multidisciplinary teams including physicians, nurses,social workers, physical therapists to ensure seamless coordination of care services.
- Created individualized care plans according to each client's needs while following protocols established by the healthcare team.
Patient Care Coordinator
Swedish Medical Center
08.2015 - 04.2022
- Provided exceptional customer service to patients, families, and healthcare providers by promptly responding to inquiries, and scheduling neuropsychological evaluations.
- Performed daily administrative duties such as filing paperwork, answering phones calls from patients, providers, insurance companies, verifying insurance eligibility. Obtaining authorizations for neuropsy services.
- Utilized electronic health records system for accurate data entry of patient information such as demographics, insurance coverage, and physician orders.
Intake Coordinator
Soundview Medical Supplies
02.2025 - Current
- Coordinated patient intake processes to ensure timely and accurate information gathering.
- Developed and maintained relationships with healthcare providers to streamline referral management.
- Implemented electronic health record systems for improved data accuracy and accessibility.
- Trained new staff on intake procedures, enhancing team efficiency and consistency.
- Provided excellent customer service to patients, family members, and healthcare providers during the intake process.
- Reduced errors in patient data entry with thorough verification processes and attention to detail.
- Completed intake assessment forms and filed clients' charts.
- Collected, verified, recorded and processed client demographics, insurance payments, and referral information.
- Collaborated with healthcare professionals to ensure patients received appropriate services and resources.
- Answered phone calls and provided new clients with required paperwork to initiate service.
- Contributed to a positive work environment through effective teamwork and open communication among colleagues.
- Communicated with referral sources, physicians, and associated staff to check documentation for proper signatures.
- Documented patient medical information, case histories, and insurance details to facilitate smooth appointments and payment processing.
- Expedited critical cases through close coordination with clinical teams, reducing wait times for essential services.
Prior Authorization Specialist
Physician Health Partners
04.2016 - Current
- Authorized and verified patient demographic and insurance for surgical, radiology, and medical procedures request in accordance with the plan guidelines (CMC).
- Developed trainings for new/current staff members on proper processes/creating process (HHC), maintained up-to-date knowledge of insurance policies and procedures related to prior authorization requirements.
- Evaluated patient's benefits eligibility using various databases and tools such as web portals, claims system and utilized electronic files to conduct authorization reviews and updates.
- Processed appeals for denied services with medicare A&G Dept. according to company policy guidelines. Stayed current with changes in rules, laws and procedures to maintain timeliness and accuracy.
- Communicated effectively both verbally and written with external customers including physicians, pharmacists, hospitals
Caregiver
Stone ridge at Centerra
02.2023 - 01.2025
- Assisted clients with daily living activities, promoting independence and enhancing quality of life.
- Monitored client health conditions, reporting changes to healthcare professionals for timely interventions.
- Developed personalized care plans in collaboration with families to meet individual client needs.
- Trained new caregivers on best practices and protocols for client care and safety procedures.
Home Health Aide
Touching Hearts at Home
06.2022 - 02.2024
- Offered companionship and emotional support to clients while assisting them with personal services, enabling patients to stay in homes.
- Assisted with activities of daily living including bathing, grooming, feeding,toileting and transferring of clients, running errands, taking client doctors appointments, house cleaning and medication reminders.
- Recorded patient information, notifying nursing staff of changing or unusual conditions through EMR.
- Collaborated with physicians, nurses, social workers, family members and other healthcare professionals to ensure quality care for patients.
Prior Authorization Specialist
Physicians Health Partners
08.2012 - 06.2016
- Authorized and verified patient demographic and insurance for surgical, radiology, and medical procedures request in accordance with the plan guidelines.
- Maintained up-to-date knowledge of insurance policies and procedures related to prior authorization requirements.
- Criteria review using Milliman Care Guidelines.
- Communicated effectively both verbally and written with external customers including physicians, pharmacists, hospitals.
Education
High School - undefined
Emily Griffith Oppertunity School
Denver03.1993
Skills
Insurance Verification
Records Maintenance
Organizational Skills
Problem-Solving
Medical Terminology
Timeline
Intake Coordinator
Soundview Medical Supplies
02.2025 - Current
Caregiver
Stone ridge at Centerra
02.2023 - 01.2025
Home Health Aide
Touching Hearts at Home
06.2022 - 02.2024
Home Health Aide
The Ridge Senior Living Facility
01.2020 - 04.2022
Prior Authorization Specialist
Physician Health Partners
04.2016 - Current
Patient Care Coordinator
Swedish Medical Center
08.2015 - 04.2022
Prior Authorization Specialist
Physicians Health Partners
08.2012 - 06.2016
High School - undefined
Emily Griffith Oppertunity School