Summary
Overview
Work History
Education
Skills
Languages
Additional Information
Timeline
Generic

Samantha Delgado

Raleigh

Summary

Experienced with coordinating patient care activities, ensuring efficient scheduling and communication. Utilizes strong organizational and multitasking abilities to manage patient needs and administrative tasks smoothly. Knowledge of healthcare protocols and patient management to maintain high standards of care.

Overview

19
19
years of professional experience

Work History

Patient Care Coordinator - Interim Reverification Supervisor

Mercalis
04.2023 - Current
  • 1. Provide inbound and outbound phone support with outstanding customer service on behalf of Janssen Pharmaceuticals.
  • Primarily serving as a regionally aligned care coordinator, which focuses on all aspects of benefit coordination and all other forms of available patient support, which may include teamwork and partnering with fellow agents to provide the best patient program support.
  • Responsible for handling healthcare provider and/or patient interactions regarding patient eligibility and enrollment.
  • 2. I worked alongside the BI leadership team, providing assistance for the Janssen Patient Assistance Program BI project.
  • Audited enrollment cases to ensure all required information was received on file in order to proceed with the completion of the Benefit Investigation case.
  • Identified trends and gaps in the process to assist with implementing new/updated processes to improve the foundation's overall success.
  • Running reports and managing trackers
  • 3. I worked alongside management on the PSC project.
  • Assisted PSC with patient enrollments to ensure proper quality of case management
  • Assisted PDE management with preparation for the 2025 re-verification process
  • 2025 Interim Reverification Supervisor
  • Responsible for new hire reverification agents performance, including coaching, mentoring, training, productivity, schedule adherence and conflict resolution
  • Responsible for ensuring SOP and program guideline are being followed
  • Hosted meetings as needed to provide updates, feedback, daily/weekly agenda and goals
  • Created spreadsheets as needed to keep track of team productivity, assign case load as needed and overall organization for all responsible duties
  • Ran daily report to ensure proper case management is completed by agents
  • Serve as point of contact between management and team
  • Identify and report all information as required by client (helpful feedback, trends, AE, etc)
  • Handle escalation cases and appeals with urgency

Office Manager

Galatians Community Health (formerly Aplus Family Care)
03.2022 - 04.2023
  • Manage ALL staff responsibilities
  • Responsible for Front Desk and Clinical Staff performance, including training, coaching, mentoring, quality assurance, schedule adherence and proper clinical quality control.
  • Responsible for maintaining patient records and proper handling of patient medical records following HIPPA guidelines.
  • Responsible for maintaining full provider schedules to ensure revenue and partnering with the billing reimbursement team to monitor flow of operations along with AR management.
  • Placing Supply Orders
  • Manage employee hours/payroll
  • Coordinate and participate in community events.
  • Provide support to ALL staff as needed and serve as point of contact between doctors, staff and CEO

Front Office Team Lead

AFC Urgent Care
08.2021 - 02.2022
  • Manage ALL front desk responsibilities and multiple team members.
  • Responsible for Admin staff performance including patient reservations along with walk-in patients, patient check in/check out, Insurance Verification and ensuring Copays or Deductibles payments are collected if applicable.
  • Responsible for creating team member schedules, schedule adherence, training, coaching and mentoring.
  • Responsible for maintaining patient records and proper handling of patient medical records following HIPPA guidelines.
  • Work closely with other team members to provide support as needed and ensure patient needs are met, including Spanish translations.
  • Complete daily closeout, deposits and reports to maintain QA/QC
  • Serve as point of contact between team members and CEO

Front Desk Team Lead - Office Coordinator

A PLUS FAMILY CARE
09.2018 - 04.2020
  • Manage ALL Front Desk responsibilities and multiple team members.
  • Responsible for Admin staff performance including patient reservations along with walk-in patients, patient check in/check out, Insurance Verification and ensuring Copays or Deductibles payments are collected if applicable
  • Responsible for maintaining patient records and proper handling of patient medical records following HIPPA guidelines.
  • Responsible for maintaining full provider schedules to ensure revenue and partnering with the billing reimbursement team to monitor flow of operations along with AR management.
  • Answer inbound calls and placing outbound calls for appointment follow up.
  • Work with the clinical team and other medical facilities to ensure all patients needs were met, including Spanish translations.
  • Train new employees.
  • Serve as Patient referral Coordinator and point of contact between team members and upper management.
  • Placing Orders along with Order Follow up on Medical Devices for patients
  • Coordinate and participate in community events.

Specialty/Operations Supervisor

The Home Depot
05.2006 - 06.2018
  • Responsible for managing various departments/multiple team members, store inventory, freight, special orders, QA/QC, ensuring company safety procedures are being followed and sale goals are being met.
  • Key Carrier responsible for opening/closing store along with training new employees.
  • Maintain and ensure assigned departments were stocked with material.
  • Work in teams to ensure all clients needs were met - including Spanish translations.
  • Organize and expedite specialty orders.

Education

High School Diploma -

Middletown High School
Middletown, NY
06-2005

Skills

  • Supervising experience
  • Operations management
  • Leadership
  • Customer service
  • Administrative experience
  • Medical office experience
  • Triage
  • Patient Care
  • Spanish
  • Bilingual
  • Microsoft Office
  • Inventory control
  • Time management
  • EMR systems
  • Medical billing and Insurance Verification
  • Medical records
  • HIPAA
  • Organizational skills
  • Data entry
  • Critical thinking skills
  • HIPAA compliance
  • Appointment scheduling
  • Insurance verification
  • Patient relations
  • Patient care coordination
  • Verbal and written communication
  • Medical terminology
  • Patient records management
  • Patient registration
  • Follow-up care

Languages

Spanish - Fluent

Additional Information

Nineteen(19) years of working deeply with multiple staff members to manage, assist, train, coach, mentor and provide overall required leadership to clients as well as co-workers.

Timeline

Patient Care Coordinator - Interim Reverification Supervisor

Mercalis
04.2023 - Current

Office Manager

Galatians Community Health (formerly Aplus Family Care)
03.2022 - 04.2023

Front Office Team Lead

AFC Urgent Care
08.2021 - 02.2022

Front Desk Team Lead - Office Coordinator

A PLUS FAMILY CARE
09.2018 - 04.2020

Specialty/Operations Supervisor

The Home Depot
05.2006 - 06.2018

High School Diploma -

Middletown High School
Samantha Delgado