Azucena
Converse,TX
Summary
Proven to enhance operational efficiency and consumer satisfaction at The Center For Health Care Services, I leverage strong analytical skills and time management expertise. Skilled in HIPAA compliance and insurance verification, I've boosted revenue collection and streamlined processes, significantly improving service delivery and financial outcomes.
Overview
15
15
years of professional experience
Work History
Patient Financial Representative
The Center For Health Care Services
Converse, TX
01.2023 - Current
- Maintained a detailed spreadsheet system for reporting HCS and TxHmL consumer services tracking of revenue and provide summary report to the Accounting Department on a weekly basis for agency budget reports.
- Entered all HCS, ISS, HH, PASHAB, RESPITE, BEHAVIOR SUPPORT, DENTAL, ADAPTIVE AIDS (AA) and MHM, Service Delivery Logs for all services for reimbursement.
- Completed all phases of insurance payment processing, payments, denials and appeals, processed, tracking and reconciliation reimbursement (payment) from CareLink and Client Fee.
- Processing all third party billing verified required information for billing. Billing includes Medicare, Medicaid, funding contracts, private insurance, and private pay.
- Processed various Munis Requisitions for the Long Term Care, IDD Unit and other units as needed.
- Provide leadership, training, and support to the Revenue Cycle Team in accordance with Revenue Cycle protocols in the absence of my manager.
- Verify Client Eligibility, Medicaid, and Financials.
- Assists Business office Administrator with the ordering of office supplies.
- Ensures all required State and 3rd party authorizations and patient funding sources are accurately entered in the Electronic Health Record (EHR).
- Oversees scheduled and unscheduled appointments at assigned clinic to determine consumer’s financial eligibility and responsibility, insurance coverage and benefits and prior authorizations requirements.
- Ensures all compliance errors are reported to the Business office Administrator and maintains records and files of documentation supporting billing changes that are directed by Business office Administrator.
- Investigates and resolves suspended services in accordance with procedure to prevent any write-offs.
- Provide effective communication between Revenue Cycle teams and multiple departments, Centralized Scheduling, Outpatient, Primary Care and Enrollment, and Billing.
- Increased efficiency in processing financial assistance applications through proactive communication with consumer’s and their families.
- Explained payment requirements, accepted payment methods and billing procedures.
- Served as a liaison between consumer’s, providers, and insurance companies, facilitating communication around financial matters.
- Enhanced revenue collection by diligently following up on unpaid claims and negotiating payment plans with consumer’s.
- Implemented effective time management strategies, consistently meeting deadlines for claim submission and follow-up activities.
- Contacted guarantors to collect payments for past due accounts.
- Ensured consumer’s privacy by adhering to all HIPAA regulations during daily tasks and interactions.
- Posted miscellaneous payments to general ledger accounts.
- Established financial arrangements for self-pay consumer’s.
- Contributed to a positive work environment by collaborating effectively with fellow team members, sharing knowledge and best practices.
- Participated in regular audits of consumer’s accounts, identifying discrepancies or potential issues that could impact revenue cycle performance.
- Improved consumer satisfaction by providing accurate and timely billing information.
- Streamlined the insurance verification process for faster reimbursement rates.
- Demonstrated strong problem-solving skills by resolving complex billing issues for both insured and self-pay consumer’s.
- Accurately reviewed and updated consumer’s and financial information.
- Provided exceptional customer service, addressing consumer concerns promptly and professionally while maintaining empathy and understanding.
- Developed a comprehensive understanding of various payer requirements and policies, resulting in fewer denied claims due to insufficient documentation or coding errors.
- Reduced billing errors with thorough attention to detail when entering consumer’s information into financial systems.
- Enhanced overall organizational profitability by assisting in the identification of underpayments and pursuing appropriate reimbursement.
- Maintained accurate records of consumer’s accounts, payments and payment plans.
- Monitored consumer’s accounts for payment delinquency and initiated collection efforts.
- Entered client details and notes into system for interdepartmental access and review.
- Researched billing errors and discrepancies to initiate corrective action.
- Analyzed consumer’s financial records to determine appropriate payment plan.
Patient Care Coordinator
Tricity Pain Associates
San Antonio, TX
08.2018 - 08.2022
- Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
- Provided exceptional customer service by addressing concerns, answering questions, and ensuring patient satisfaction with their care experience at the clinic.
- Assisted patients with completing necessary paperwork and forms to provide healthcare facilities with essential information to bill for services.
- Enhanced patient satisfaction by efficiently scheduling appointments and managing patient flow.
- Streamlined communication between patients and healthcare providers, ensuring timely responses to inquiries and concerns.
- Worked closely with patients to deliver excellent and direct individualized patient care.
- Trained new staff members on office procedures and protocols, ensuring consistency in patient care delivery.
- Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
- Acted as main point of contact for patients, doctors, and hospital staff by closely reviewing medical charts and maintaining high levels of communication.
- Coordinated with insurance companies for accurate billing and claim processing, reducing errors and financial discrepancies.
- Upheld confidentiality requirements and regulatory compliance guidelines.
- Assisted patients with coordinating long-term care for chronic conditions to support and manage illnesses.
- Conducted regular audits of documentation accuracy within the practice management software, addressing discrepancies promptly for better data integrity.
- Verified patient insurance eligibility and entered patient information into system.
- Helped address client complaints through timely corrective actions and appropriate referrals.
- Recommended service improvements to minimize recurring patient issues and complaints.
Financial Specialist
USAA Federal Savings Bank
San Antonio, TX
03.2012 - 08.2019
- Enhanced financial decision-making by providing timely and accurate analysis of financial data to executive leadership.
- Collaborated with cross-functional teams to develop strategic plans aligned with overall company objectives.
- Developed comprehensive financial models for forecasting, budgeting, and performance tracking purposes.
- Ensured compliance with regulatory standards by conducting regular audits and implementing necessary corrective actions.
- Initiated conversations with clients to uncover financial needs, cross-sell products and services and make referrals to business partners to meet sales goals.
- Improved financial reporting accuracy by streamlining data collection processes and implementing automated solutions.
- Optimized working capital management by monitoring accounts receivable/payable balances and negotiating favorable terms with vendorscustomers.
- Executed financial assurance audits and implemented new control points and metrics to support business changes.
- Contributed to the development of long-term financial plans that support organizational growth goals while maintaining fiscal responsibility.
- Studied financial documents to identify potential areas needing improvement.
- Educated clients on potential risks and rewards associated with various investments.
- Devised comprehensive financial plans for clients to achieve short and long-term financial goals.
Licensed Personal Banker
Wells Fargo, NA
San Antonio, TX
09.2009 - 03.2012
- Collaborated with team members to ensure seamless service delivery during high-volume periods or staff shortages.
- Developed strong relationships with local businesses as part of community outreach efforts aimed at expanding the bank''s presence in the area.
- Established rapport with clients through attentive listening, understanding their financial needs, and recommending suitable products and services.
- Increased customer satisfaction by diligently addressing inquiries, concerns, and providing personalized banking solutions.
- Streamlined operational efficiency by maintaining accurate records of all transactions and ensuring timely account updates.
- Ensured a secure environment for sensitive information by strictly adhering to data protection policies and regulations.
- Boosted overall client retention rate through proactive communication about promotions or product updates relevant to individual needs.
- Implemented effective referral strategies to establish relationships with potential customers and boost branch growth.
- Mentored new employees on company policies, procedures, and best practices in personal banking services.
- Conducted comprehensive financial assessments for clients seeking loans or credit approval, contributing to prudent lending decisions.
- Maintained up-to-date knowledge of industry trends, regulations, and competitor offerings to provide informed advice to clients.
- Continuously improved knowledge of financial products and services through ongoing training, staying abreast of market trends and changes in regulations.
- Enhanced customer loyalty by offering exceptional service during account openings, loan applications, and credit card processing.
- Contributed to branch sales goals by proactively identifying opportunities for cross-selling and upselling banking products.
- Exceeded performance metrics consistently throughout tenure as Licensed Personal Banker through diligent work and commitment to customer satisfaction.
- Provided exceptional support during audits by maintaining accurate records and collaborating with internal teams to ensure compliance with all regulatory requirements.
- Resolved customer complaints and disputes to maintain satisfaction and loyalty.
- Cultivated strong customer relationships by providing tailored advice and services.
- Processed customer requests for statements, ordering additional checks, and updating customer personal information in database.
- Answered customer questions and explained available services such as deposit accounts, bonds, and securities.
- Continually boosted branch production and revenue by Number% by consistently meeting all monthly and quarterly sales goals.
- Presented new and additional products and services to existing customers.
- Collected customer information and completed new account forms.
- Interviewed customers to obtain information needed for opening new accounts or renting safe-deposit boxes.
- Contacted customers as soon as issues arose to immediately find resolution before problem escalated.
- Processed customer payments and account setup charges.
- Reconciled customer accounts and balanced daily transactions.
- Tracked and processed customer account requests and applications.
Education
Associate Of Business Finance - Finance
City of Angels
Sylmar, CA01.1999
Skills
- HIPAA Compliance
- Time management expertise
- Insurance Verification
- Strong analytical skills
- Payment Processing
- Medical billing knowledge
- Verbal and written communication
- Claims Processing
- Data entry proficiency
- Attention to Detail
- Analytical and Critical Thinking
- Insurance Company Communication
Languages
Spanish
Native or Bilingual
English
Full Professional
Timeline
Patient Financial Representative
The Center For Health Care Services
01.2023 - Current
Patient Care Coordinator
Tricity Pain Associates
08.2018 - 08.2022
Financial Specialist
USAA Federal Savings Bank
03.2012 - 08.2019
Licensed Personal Banker
Wells Fargo, NA
09.2009 - 03.2012
Associate Of Business Finance - Finance
City of Angels