Work History
Education
Skills
Timeline
Languages
Academic Awards
References
Hobbies and Interests
BusinessAnalyst
Amalia Ayala

Amalia Ayala

Health care Representative
Hamden,CT

Work History

Patient Financial Access Specialist/Emergency Room Registrar

Yale New Haven Hospital
05.2005 - Current
  • Responsible for patient registration in the Emergency Department (EDR) for multiple campus locations including Pediatric ED
  • Admitting Department and Labor and Birth Maternity Administration.
  • Ensure all patient registration is accurately entered in the EPIC system including demographic, insurance, and financial information.
  • In-depth knowledge of the hospital's operations, policies, procedures, and handling of highly confidential information
  • Trained new staff.
  • Facilitated communication between providers, patients, and insurance companies to resolve any issues related to coverage or authorization requests effectively.
  • Provide exceptional customer service while managing high call volumes, addressing inquiries quickly, and maintaining professionalism at all times.
  • Maintained strict confidentiality of sensitive patient data in compliance with HIPAA regulations, safeguarding personal information from unauthorized access or disclosure.
  • Leveraged knowledge of various software platforms to optimize management of patient information. Assist with daily work tasks development workflow delegation.
  • Organized and detail-oriented with strong work ethic. Adaptable and proficient in learning new concepts quickly and efficiently.
  • Exercised leadership capabilities by successfully motivating and inspiring others. Demonstrate creativity and resourcefulness through development of innovative solutions.
  • Answered phone calls and messages for the Admitting Department, Maternity, Direct Admit, scheduled appointments, and handled patient inquiries.

Administrative Assistant/ER Specialist

Connecticut Children's Medical Center
09.2003 - 05.2005
  • Responsible for coordinating the pre-registration process for patients including insurance verification and billing for patient accounts
  • Managed communications concerning patients' financial matters including communicating costs to patients' family
  • Identified problems of eligibility for outpatient services and ensured proper resolution on time.
  • Delivered excellent customer service through prompt responses to client inquiries, addressing concerns effectively, and building strong relationships.

Medical Claims Examiner

Anthem Blue Cross Blue Shield
01.1989 - 09.2003
  • Responsible for reviewing claims to ensure proper guidelines and processes have been followed in submission
  • Process claims including documenting and validating all information for accuracy and completeness
  • Reviewed claims to determine if costs were reasonable for services provided
  • Resolved medical claims by approving or denying documentation, calculating benefit due, initiating payment, or composing a denial letter
  • Ensured files were kept current to reflect all appropriate forms, statements, and reports
  • Assist medical billing and reimbursement teams with front-end processing to ensure payments were processed in a timely manner
  • Knowledgeable of medical terminology and procedures and leveraged information to ensure claims contained proper naming convention.

Education

MBA - Business Administration And Management

Albertus Magnus College
New Haven, CT
05.2024

Bachelor of Science - Business Administration And Management

Albertus Magnus College
New Haven, CT
05.2023

Associate of Science - Business Administration

Albertus Magnus College
New Haven, CT
05.2021

Skills

  • Spanish Fluency
  • Claims Handling and Coverage Verification
  • Caring and Empathetic
  • Customer Service
  • Communicating to Patients and Families
  • Insurance verifying
  • Punctual and Hardworking
  • Building Rapport and Credibility
  • Word Processing
  • Reliability and Dedication
  • Medical Services Administration
  • Patient interviewing
  • Benefits Explanation
  • Data Collection
  • Providing Information and Resources
  • Professional Bedside Manner

Timeline

Patient Financial Access Specialist/Emergency Room Registrar

Yale New Haven Hospital
05.2005 - Current

Administrative Assistant/ER Specialist

Connecticut Children's Medical Center
09.2003 - 05.2005

Medical Claims Examiner

Anthem Blue Cross Blue Shield
01.1989 - 09.2003

MBA - Business Administration And Management

Albertus Magnus College

Bachelor of Science - Business Administration And Management

Albertus Magnus College

Associate of Science - Business Administration

Albertus Magnus College

Languages

Spanish
Native or Bilingual

Academic Awards

Deans List, 09/01/19, 2020,2021,2022,2023,2024

Kappa Gamma Pi

The National Catholic College Graduate Honor Society

Cum Laude

References

Maria Melendez, New Haven, CT, Mayors Office, 203-946-8200

Michelle Mastrianni, New Haven, CT, Yale Health Plan, 203-688-4242

Danette Barnett, New Haven, CT, Yale Health Plan, 203-688-5135

John Leavitt, New Haven, CT, Yale Health Plan, 203-688-4246

Hobbies and Interests

  • Reading
  • Cooking
Amalia AyalaHealth care Representative