ARELY MARTINEZ
Spring
Summary
Seasoned Patient Facing Revenue Cycle Supervisor with 20 years in healthcare administration primarily in leadership. A proven track record in enhancing patient experience. Expert in insurance verification and patient account management, coupled with strong leadership and analytical skills. Achieved significant improvements in process efficiency and team productivity, demonstrating a high level of integrity and customer relations acumen.
Overview
22
22
years of professional experience
Work History
Revenue Cycle Supervisor
Texas Oncology
04.2021 - 12.2024
- Monitor and oversee all administrative areas of our clinics operations for 19 Providers and 3 clinics
- Manage all Patient Facing areas from New Patient Intake Department, Scheduling, Surgery Scheduling, Radiology and Surgery Authorizations, Front desk coordinators, to Financial Clearance department
- Oversee and audit metrics to ensure KPI's are met according to company's goals.
- Review clinic workflows for efficiency and implement new processes along with monitoring for effectiveness and productivity
- Review staffing metrics are appropriate based on clinic needs
- Provide Root Cause Analysis trends for our Rejections /Denials/ Aged Accounts for office/hospital visit charges, chemotherapy/specialty drugs, and surgery charges
- Reviewed uninsured accounts, verifying medical assistance application process, charity care application and drug replacement program availability
- Verified technical reimbursement questions for providers, billing and coding staff
- Researched rejections, investigating problems to appeal claims
- Identified opportunities for coverage access to address reimbursement barriers
- Audit Adjustment trends to identify cause of denial/ submit appeals based on insurance and deadlines
- Responsible for interviewing, onboarding and coaching team members
- Work with Management team on onboarding new Providers and build schedules per Providers Preferences
- Serve as a patient Advocate and guide to help obtain Health Insurance and any billing concerns for both internal and external bills
- Issued work schedules and submitted teams daily timesheets
- Interacted with insurance companies to obtain authorization for medical services rendered by providers
- Evaluated revenue cycle processes and established actionable methods to increase productivity and efficiency
- Monitored revenue and compared to targets to address variances and resolved actual-to-budget variances
- Reviewed reports on employee attendance, productivity and effectiveness to evaluate performance
- Discussed job performance problems with employees, identifying causes and issues to find solutions
- Created reports on key performance indicators related to the revenue cycle
- Trained employees on best practices and protocols while managing teams to maintain optimal productivity
- Implemented departmental policies and standards in conjunction with management to streamline internal processes
- Conducted regular staff meetings to enhance communication, address concerns, and implement process improvements
Financial Counselor
Houston Methodist West Campus
01.2019 - 12.2020
- Educate patients regarding their insurance benefits for inpatient & outpatient
- Assist patients with billing concerns for both hospital balances and separate entities
- Complete estimates for both patients and Physician offices based on services needed
- Financially clear patients by collecting minimum deposit required and set patients on payment plans
- Screen patients for Charity when needed and submit proper documentation
- Provide support for Labor Delivery admitting representative
- Review monthly expected collection trends
- Assist in cross training staff
- Served as a point of contact for patient inquiries and concerns, resolving issues promptly and professionally
Call Center Team Lead
Gutierrez Communications
08.2017 - 01.2019
- Train call center and chat representatives
- Conducted audits on inbound and outbound calls to ensure QA standards are met
- Obtain demographics and enroll customers for roadside assistance coverage
- Address customers service inquiries in a timely and accurate manner
- Verify customers coverage to determine proper roadside assistance available to them
- Assisted supervisor to ensure call center coverage
- Provided ongoing coaching and feedback to call center agents to improve customer satisfaction scores
- Conducted regular performance evaluations for call center agents, recognizing top performers and identifying areas for improvement
- Assisted with escalated customer inquiries or complaints, resolving issues promptly while maintaining professionalism and empathy
- Coordinated staffing schedules based on forecasted call volumes ensuring adequate coverage during peak hours
Financial Counselor/ Front End Supervisor
UT Physicians
10.2016 - 07.2017
- Supervise and train front office staff in registration, scheduling, insurance verification
- Screen/ qualify patients for financial assistance program
- Assist patients in obtaining Marketplace insurance plans or Medicaid/ Chip
- Ensure insurance verifications were accurate for office visit/ sick visits
- Coordinated staff training and development programs, resulting in improved clinical skills and patient care
- Managed inventory of medical supplies and equipment, optimizing procurement processes and reducing costs by XX%
- Scheduled and coordinated patient appointments, procedures, and surgeries, optimizing clinic resources
- Handled patient complaints and concerns, addressing issues promptly and ensuring patient satisfaction
- Conducted regular staff meetings to enhance communication, address concerns, and implement process improvements
- Coordinated outreach and community engagement initiatives to attract new patients and promote the clinic's services
- Supervised clinic maintenance staff, ensuring a clean and organized healthcare facility
- Monitored clinic security measures and implemented safety protocols to protect patients and staff
- Tracked and analyzed clinic KPIs, identifying areas for improvement and implementing corrective actions
- Conducted regular audits of clinic processes and procedures to identify inefficiencies and opportunities for improvement
ER Team Lead
North Cypress Medical Center
11.2007 - 10.2016
- Employee scheduling for Main ER and 4 Free Standing ER facilities
- Train and supervise about 40+ registration clerks for ER/ Cross Train for outpatient departments from check in point to discharge / IV / Scheduling / Verify Demographics
- Cross cover in Outpatient Call Center / PBX / Outpatient Radiology
- Maintain Audit trends in our Monthly Expected Collections
- Cross Train staff for outpatient depts, Breast Center, Sleep Center, Radiology, Lab Main Admitting & PET CT Department
- Assisted Director in interview processes /disciplinary actions
- Organized staff meetings consistently to maintain processes and communication with teams
- Monitored team performance and provided regular feedback to drive continuous improvement
- Collaborated with cross-functional teams to identify process improvements and implement best practices
- Implemented a reward system to recognize top performers, boosting morale and motivation levels
- Served as a liaison between upper management and the team, effectively communicating goals, objectives, and expectations
- Coordinated schedules for optimal coverage during peak periods or special events
- Ensured compliance with company policies, procedures, safety regulations at all times
- Demonstrated strong problem-solving abilities when faced with unexpected challenges or obstacles
Clinic Manager
Pearle Vision
03.2003 - 12.2006
- Supervise and train clinical staff on both administrative and clinic duties
- Conducted interviews with Optometrist
- Oversaw the hiring, training, and performance evaluations of clinic staff
- Collaborated with physicians and other healthcare professionals to optimize patient care delivery
- Maintained accurate records of patient appointments, treatments, and medical histories
- Managed inventory levels and ordering of medical supplies to ensure adequate stock at all times
- Led regular staff meetings to communicate updates, address concerns, and foster teamwork
- Ensured compliance with HIPAA regulations regarding patient privacy and confidentiality
- Created employee schedules that optimized staffing levels based on patient demand patterns
- Conducted regular audits to monitor billing accuracy and identify areas for improvement
- Collaborated with insurance companies to resolve billing issues and maximize reimbursement rates
Education
MedVance Institute -
MedVance Institute
01.2007
High School -
Cypress Springs High School
06.2002
Skills
- Supervising Experience
- Patient account management
- Availity
- Athena IDX
- Outstanding work ethic
- Collections management
- PMD
- Insurance coordination
- HIPAA
- Patient registration
- Office Administration
- Bilingual English & Spanish
- Expense management
- Leadership Experience
- Exceptional customer service
- Ability to work under stress in fast paced environment
- IknowMed G2
- Detail Oriented
- Medical Records Management
- Interview & Coaching experience
- Ability to ensure team members maintain a balance workload
- Healthcare compliance
- Passport
- Cash flow forecasting
- Centricity
- Revenue performance
- Meditech
- Teamwork and collaboration
- Microsoft Office
- Time management
- Workday
- Problem-solving abilities
- Possess high level of integrity
- Reliability
- Patient Care
- Excellent communication
- Strong people management skills
- Organizational skills
- Root Cause Analysis
- Adaptability and flexibility
- PenRad
- Decision-making
- Payment posting
- Team building
- Insurance verification
- Handling complaints
- Critical thinker and decision maker
- Administration and operations
- Excel
- Denial resolution
- Conflict resolution
- Recruitment and hiring
- Motivational leadership
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Revenue Cycle Supervisor
Texas Oncology
04.2021 - 12.2024
Financial Counselor
Houston Methodist West Campus
01.2019 - 12.2020
Call Center Team Lead
Gutierrez Communications
08.2017 - 01.2019
Financial Counselor/ Front End Supervisor
UT Physicians
10.2016 - 07.2017
ER Team Lead
North Cypress Medical Center
11.2007 - 10.2016
Clinic Manager
Pearle Vision
03.2003 - 12.2006
High School -
Cypress Springs High School
MedVance Institute -
MedVance Institute
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