Karin Martinez

Experience

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  Publix Super Markets

  Jul 2002 - Feb 2008

  Apron's Clerk

  - Demonstrated and clarified bi-weekly meal recipe to upsell products and instill consumer confidence- Cleaned cooking vessels and utensils to uphold health codes for use in consumption of food - Organized and maintained display and work area - Assisted in dessert preparation, finishing, packaging, and labeling

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  Florida International University

  Aug 2006 - May 2012

  Game Room Student Coordinator

  Supervised a student staff of 4-5Reviewed staff development of event programming Calculated and reported revenue to business office; assisted with annual budget planningObtained quotes for events and site purchases Drafted work schedules throughout the year to accommodate shifting student availabilityOversaw cleanliness and maintenance of site Developed traffic reports which lead to more effective event planning, new services, and better understanding of site utilization

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  Independent Living Systems, LLC

  Jun 2012 - Apr 2016

  Assisted in orientation and training of new personnelResearched and connected member with community-based resources Conducted telephonic assessments periodically to verify accuracy of clinical and non-clinical dataReviewed care plan with interdisciplinary care team Maintained accurate and timely documentation via electronic care management system, eCareParticipated in special task force for the purpose of record remediation. This involved traveling out of state, performing nursing home visits to evaluate needs and formulating goals to improve quality of life, connect patients with benefits, communicate with staff and family to coordinate adherence to care plan, obtaining legal documents, updating all necessary information on care management system Show less Managed all inquiries of the call center. Duties included investigation of questions/complaints, forward issues to appropriate parties if needed, request order overrides for eligible members, replace orders when reported missing or damaged, member notification of eligibility and benefitsFacilitated order placement, as well as analyzed order information to resolve issues and concernsCommunicated with insurance to verify eligibilityAdministered nutritional assessmentsInvestigated and updated physician information Show less

  • Non-Clinical Care Manager

    Jun 2014 - Apr 2016

  • Care Coordinator

    Oct 2013 - Jun 2014

  • Call Center Agent

    Jun 2012 - Oct 2013
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  Miami Jewish Health

  Apr 2016 - Jan 2019

  Case Manager

  Completed quarterly in-person or monthly telephonic assessments for caseload of 60 members Worked in tandem with member, family, and healthcare providers to resolve issues in member’s careParticipated in routine interdisciplinary care team meetings Coordinated services with community providers and submitted authorizations for processing

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  Simply Healthcare Plans

  Jan 2019 - Apr 2019

  LTSS Service Coordinator

  Completed monthly telephonic contacts and quarterly in-person assessmentsEffectively utilized health plan benefits to fulfill member’s needsDeveloped and maintained individualized care plans for each memberCoordinated services with community providers and submitted authorizations for processing Conducted daily telephonic contacts or weekly in-person visits with inpatient members

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  Blue Sky Home Healthcare, Inc.

  Aug 2019 - Dec 2019

  Intake Coordinator

  Responsible for receiving and reviewing home health care orders from hospitals and clinicsTasked with verifying eligibility for new and recurring patients prior to admissionScheduled appropriate home care staff in a timely manner in accordance with Medicare guidelinesReceived and sorted mail, packages, faxes, and emails to appropriate staffAnswered incoming calls and received all incoming visitors to officeReviewed staff time sheets for accuracy and submitted payroll reports to administratorPlaced orders for medical and office supplies Show less

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  MEDICAL DECISION SERVICES

  Dec 2019 - now

  Intake Coordinator

  Provided excellent service by greeting, screening, and directing all incoming calls and visitorsProcessed incoming/recurring orders in EMR system Brightree for DME such as CPAP/BIPAP, oxygen, suction machine, tracheostomy, and ventilatorsReviewed and analyzed medical records to determine if medical necessity requirements met for state and commercial insurancesRequested Medicare and commercial insurance eligibility, benefits, and authorizations via phone, fax, and provider web portals such as myCGS, Availity, CareCentrix, UnitedOne, and Wellcare.Responsible for collecting and processing payments Show less