Tarence Rodriguez
Katy,TX
Summary
Highly efficient Healthcare Administrator with strong administrative expertise and public sector background with excellent organizational and collaborative skills leading to outstanding results. Passionate worker with a proven record of accomplishments bringing forth the necessary skills and work ethic to support productivity and job efficiency with more than 10 years of experience. Seeking a full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills in business and health administration.
Overview
12
12
years of professional experience
Work History
Department Assistant Lead
Texas Children’s Hospital
04.2016 - Current
- Prepares and submits vendor and physician contract renewals for the department
- Manages credentialing, reimbursements and licensing renewals
- Maintains time cards and calendars
- Coordinates trips, meetings, events and travel accommodations
- Initiates and schedules surgeries, peer-to-peer reviews as recommended and needed
- Maintains clinic openings, closings, add –ons when needed
- Maintained high levels of customer satisfaction through diligent scheduling coordination, ensuring all deliverables were met within agreed timeframes.
- Opened and properly distributed incoming mail to promote quicker response to client inquiries.
- Optimized organizational processes by effectively managing crew schedules while adhering to contractual restrictions.
- Consistently met deadlines by effectively allocating resources, tracking progress, and making necessary adjustments to schedules as needed.
- Facilitated smooth handovers between shifts by creating comprehensive documentation of completed tasks and pending items for follow-up action.
- Performed wide-ranging administrative, financial and service-related functions.
- Completed daily logs for management review.
- Oversaw and verified adherence to government regulations by maintaining sensitive data and complying with international laws.
- Improved overall workflow efficiency by collaborating with team leads to identify bottlenecks, establish priorities, and develop solutions for process improvement.
- Maintains daily operations, training new hires along with coaching and development
Ambulatory Service rep.
Clear Point - Texas Children’s Hospital
12.2015 - 04.2016
- Check patients in/out after medical appointments verify patient, benefits, assist with scheduling of appointments
- Answer multi-line phone system assist as needed.
- Delivered support to medical staff in completion of patient paperwork.
- Reviewed account information and explained charges and other related inquiries from patients and insurance carriers in person or via telephone.
- Verified patient insurance eligibility and entered patient information into system.
- Trained new hires on department procedures, protocols, software usage, fostering an environment of teamwork and knowledge sharing among colleagues.
- Maintained strict confidentiality of patient information in adherence to HIPAA guidelines, ensuring privacy protection at all times.
- Proactively identified areas for process improvement within ambulatory services operations, suggesting solutions for increased effectiveness.
- Answered incoming calls, scheduled appointments and filed medical records.
- Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
- Contributed to a positive work environment by maintaining open communication with team members and supporting cross-functional tasks as needed.
- Established strong professional relationships with patients and their families, fostering trust in the ambulatory service and enhancing patient loyalty.
- Collaborated with clinical staff to facilitate smooth patient flow, reducing delays and improving overall efficiency.
- Supported clinic operations with accurate data entry and document management, facilitating timely billing and insurance claim processing.
- Helped address client complaints through timely corrective actions and appropriate referrals.
- Reduced no-show rates through consistent follow-up calls about upcoming appointments leading to better time management.
Surgery Scheduler
Houston Surgery Center (TEMP)
06.2015 - 10.2015
- Schedule surgeries, correspond with commercial carriers, multiline phone system, and insurance verification, update patient demographic, receptionist duties, correspond with physician, suppliers and vendors as needed
- Order and maintain office supplies and needs.
- Updated patient records to reflect upcoming surgeries and medical histories.
- Educated patients on pre-surgery requirements, such as fasting protocols or medication adjustments, resulting in fewer complications on the day of the procedure.
- Organized all necessary documentation for successful completion of medical audits related to surgery scheduling practices.
- Collated pre-operative lab and imaging results to facilitate surgery planning.
- Processed medical insurance claims and payments.
- Arranged pre-operative and post-operative appointments for surgical patients.
- Frequently double-checked patient histories and current information while scheduling follow-ups and other appointments.
- Verified insurance coverage and obtained pre-authorizations.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Developed relationships with referring physicians'' offices, fostering strong communication channels that benefitted both parties in coordinating patient care.
- Acted as a liaison between patients, insurance carriers, and the surgical team to secure necessary authorizations for timely procedures.
- Greeted visitors and initiated triage processes for clients to streamline patient flow.
Claims Analyst
Jacobson Group
10.2013 - 05.2015
- Receive inbound calls, processing of outpatient claims, insurance verification, updating member and provider demographics
- Processing claims appeals and overturned denials.
- Maintained strong working relationships with third-party vendors, such as independent adjusters and appraisers, to facilitate prompt resolution of claims.
- Conducted thorough investigations into each claim, gathering relevant data and documentation to support decision-making processes.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Reduced claims processing time by implementing efficient analytical techniques and strategies.
- Continuously sought opportunities to streamline workflows and implement process improvements within the claims department, resulting in increased efficiency and productivity levels.
- Evaluated original investigation reports and documents to resolve secondary concerns.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.
Subject Matter Expert (SME)
United Healthcare
05.2012 - 10.2013
- Inbound/Outbound calls, corresponds with members, providers and healthcare facilities
- Processing of commercial and state funded plans, update member and provider democracies, credentialing, physician and health plan contract review, escalated calls, deadline driven reports, scheduling conferences, training new hires along with coaching and development
- Developed effective training materials for diverse audiences, resulting in improved skillsets and increased job satisfaction.
- Developed effective improvement plans in alignment with goals and specifications.
- Served as a liaison between technical experts and business stakeholders to ensure alignment on project objectives and deliverables.
- Collaborated with management to identify and prioritize new development concepts.
- Devised and implemented processes and procedures to streamline operations.
- Designed custom curricula tailored to specific client requirements, leading to higher engagement rates during training sessions.
- Streamlined processes to increase efficiency, enabling teams to complete tasks ahead of schedule.
- Improved user productivity and efficiency through system training and support.
Education
Bachelor of Science - Business And Health Administration
Southern New Hampshire University
Hooksett, NH12.2023
Skills
- Medical terminology
- Medical Records
- Electronic Medical Records
- Medical Billing
- Appointment Scheduling
- Problem Solving
- Decision Making
- Critical Thinking
- Interpersonal Communication
- Adaptability
- Analytical Thinking
- Compliance
- Coding
- Public Health
- Conflict Resolution
- EMR
- EPIC
- Patient Relations
- Office Management
- Medical Records Maintenance
- Invoice Preparation
- CPT Coding
- Schedule Management
- Collaboration and Teamwork
- Organization and Time Management
- Budget Development
- Information Systems Development
Timeline
Department Assistant Lead
Texas Children’s Hospital
04.2016 - Current
Ambulatory Service rep.
Clear Point - Texas Children’s Hospital
12.2015 - 04.2016
Surgery Scheduler
Houston Surgery Center (TEMP)
06.2015 - 10.2015
Claims Analyst
Jacobson Group
10.2013 - 05.2015
Subject Matter Expert (SME)
United Healthcare
05.2012 - 10.2013
Bachelor of Science - Business And Health Administration
Southern New Hampshire University
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