Rogelio Osuna, Mba Email & Phone Number

San Diego Metropolitan Area

Responsible for assessing and decreasing risks associated with patient incidents. Work closely with the Quality and Compliance Director and Quality Assurance Manager on improving patient experience through the investigation of their grievances. Develop, implement, and evaluate activities related to improve the PACE participant’s satisfaction and adhere to.

San Diego, California, United States

Assist the Quality and Compliance Director and QA Manager in all activities related to the PACE (Program of All-Inclusive Care for the Elderly) Quality Management Program, including annual review and update of the quality improvement plan, development and implementation of program-wide and center-specific quality indicators, data management, education and.

San Diego, California, United States

Responsible for the initial screening and coordination of new participants to the San Diego PACE (Program of All-Inclusive Care for the Elderly) program. Responsible for working with the PACE Marketing Manager to implement the program’s intake, enrollment, outreach, and marketing activities.Responsibilities:- Conducted San Diego PACE program eligibility.

Tijuana, Baja California, Mexico

Responsible for verifying patient's dental insurance benefits and eligibility to ensure timely reimbursement. Serve as a liaison between patients and their US dental insurance companies.Responsibilities include:- Establish relationships and maintain open communication with third party payors.- Responsible for claim processing and resolve any claim.

Mexico City Area, Mexico

Responsable for overseeing the management of 4 short-term rental properties in the historic center of Mexico City.

Chula Vista, CA

Responsible for the supervision of the IHA Outreach Specialists. Conduct weekly and monthly audits to ensure accuracy and compliance. Provide guidance to staff regarding priorities, IHA scheduling, proper documentation and coding. Control performance benchmarks and timeliness by monitoring telephone calls and reviewing multiple reports.Responsibilities.

Chula Vista, CA

Ensured that enrollment processes were accomplished in a timely and efficient manner. Made recommendations for system and process enhancements to improve data accuracy. Provided training to users and new employees on eligibility processes and functionalities. Created and managed the content of all customer marketing materials.Responsibilities:- Maintained.

Chula Vista, California, United States

Provided assistance to customers, providers, and potential members regarding eligibility, benefits, and solving any issues related to their health needs.Responsibilities: - Clearly and effectively explained benefits, eligibility, claim status, guidelines, and services both to members and providers.- Adhered and met all productivity service levels in the.

Chula Vista

Responsible for accurately maintaining accounts payable and recovering any over-payment of funds.Responsibilities:- Accurately processed and analyzed electronic claims for Medicaid and Medicare lines of business.- Researched and processed second payer claims, coordination of benefits, coverage and adjudication.- Applied Medicare and Medicaid claim policies.

Master Of Business Administration (Mba), Business Administration And Management, General

Bachelor Of Arts (Ba), Graphic Design