Patrick Navarro Email & Phone Number

• Ensure processing in accordance with regulations, compliance standards and policies and procedures.• Produce high quality work related member cases while meeting performance timeframes.• Collaborate with internal Kaiser staff, other MS Departments, managers and physicians while ensuring compliance, documentation and enhancing members’ experience.• Ensuring integrity of department database by thorough, timely and accurate entry.• Mentors others in preparation for positions increased responsibility, participates in departmental meetings, trainings and audits as requested.• Answers questions and manages members on existing and open cases.

• Ensure processing in accordance with regulations, compliance standards and policies and procedures.• Produce high quality work related member cases while meeting performance timeframes.• Collaborate with internal Kaiser staff, other MS Departments, managers and physicians while ensuring compliance, documentation and enhancing members’ experience.• Ensuring integrity of department database by thorough, timely and accurate entry.• Mentors others in preparation for positions increased responsibility, participates in departmental meetings, trainings and audits as requested.• Answers questions and manages members on existing and open cases.

Stanford, California

• Initiate, follow-up, and secure insurance authorizations via phone, web, or fax. • Collaborating with Infusion Nursing Staff to process same day treatment add-ons and changes to treatment. • Initiate Financial Counseling when appropriate, including discussion of financial assistance applications, drug manufacturer co-payment assistance programs, and referral to Social Workers. • Collaborate with Patient Financial Services to provide pricing and payment options for self-pay patients. • Collaborating with Clinical Trial Coordinators to provide insurers with the specific documentation necessary to secure authorization for patients enrolled in a clinical trial. • Coordinating with the clinical care team to communicate with insurers on appeals, peer-to-peer reviews, and off-label drug programs. • Completing applications and coordinating with SHC Pharmacy and pharmaceutical manufacturers to secure patient drug replacement programs. • Ensure treatment regiments match diagnosis codes under NCCN or FDA guidelines. Communicate discrepancies to clinical care teams in a timely manner. Match treatment guidelines to diagnosis in cases of off-label prescription. Discuss coverage options with providers and patient’s in cases of off-label treatment plans. • Review and manage EPIC system work list and other information pathways to maintain accurate authorization requests. • Serve as a resource on reimbursement questions for patient’s, clinical care teams and other staff.

Sacramento, California

• Ensure the program is delivered properly and effectively, responsible for managing the overall department and office operations.• Developed, implemented and delivered reporting metrics to measure and monitor employee productivity and overall performance of the department.• Coordinates and assists with work flow and processing between department and all clinics across the UC Davis Health system. • Serves as department trainer, team leader and resource person for staff for all administrative and IT questions.• Serves as department supply buyer of medical and office supplies. • Staff Scheduler, maintaining work schedules, calendars and time off requests for all staff.• Safety Officer, ensures compliance with all workers’ compensation and workplace regulations and procedures.• Provides administration coverage during scheduled vacations, leaves of absence and sick leave.• Principle department liaison responsible with coordinating with IT, Furniture and Telecommunication units with completion of department construction.

Palo Alto, California

• Responsible for completing patient admission and registration functions.• Appointed EPIC super user by management, assisting with updates and trouble shooting for fellow employees.• Identify patients’ insurance coverage or existing financial resources to pay for medical care and services, assist with patient inquiries regarding insurance benefits and payer specific requirements.• Handle routine customer service inquiries and problems.• Process necessary admission/registration paperwork and obtains necessary documents for billing and compliance requirements.• Secure handling and accurate recording of payments collected at the point-of-service delivery.

San Bruno, California

• North East region patient case manager and site coordinator for over 20 medical facilities nationwide for patient BOTOX reimbursement.• Collaborate and assist directly with physicians with patient’s claims denials for appeals processing.• Provide patients with assistance with out of pocket co-pays and non-coverage through the use of Botox Reimbursement programs.• Educated sales representative, nurses and physicians on Insurance Verification enrollment processes and program processes.• Daily updating of Insurance medical policies and processing for specific billing and coding.

San Francisco, California

• Provided customers with financial education and financial assistance.• Helped manage customer’s accounts through deposits and withdrawals.• Provided information regarding account specifications and information.• Daily processing of local business accounts.

Brisbane, California

• Daily registration of incoming guest and ending processes for outgoing guests into hotel database. • Daily filing of customer and guest billing and personal information.• Reservation processing for guests over the phone and online.• Monitored guest hotel charges and maintained hotel necessities stocking.

Bachelor Of Science (B.S.), Health Science/Public Health

Associate Of Science (As), Allied Health And Medical Assisting Services

Associate Of Arts (A.A.), Liberal Arts And Sciences/Liberal Studies