Belinda Villarreal
Corpus Christi,TX
Summary
Results-driven Network Management Consultant with 14+ years of experience servicing professional providers and providing strategic contracting negotiations. Seeking a position as a Sr Network Management Consultant. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
23
23
years of professional experience
Work History
Network Management Consultant
Blue Cross Blue Shield Of Texas
06.2009 - Current
- Responsibilities as Network Management Consultant include contracting negotiations for physicians, medical groups, and providing support for network provider recruitment. I've worked on complex and huge negotiations that include hospital owned professional provider entities that required many modeling iterations, and collaboration with multiple areas.
- Ability to analyze data, network systems, and make recommendations.
- Skilled at working independently and collaboratively in a team environment.
- Participated in team projects, demonstrating ability to work collaboratively and effectively.
- Identified issues, analyzed information, and provided solutions to problems
- Cultivated interpersonal skills by building positive relationships with others.
Patient Access Service ER Team Lead
Christus Spohn Hospital Shoreline
01.2007 - 06.2008
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Stayed calm under pressure and successfully dealt with demanding situations.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Providing excellent customer service by promptly answering patient inquiries.
- Received patient deductibles and co-pay amounts and discussed options to satisfy the remainder of patient financial obligations.
- Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Resolved patient billing issues in line with established guidelines.
- Educated patients on the importance of preventive health care and insurance coverage.
- Addressed bad debts in line with set protocols.
- Verified patient insurance eligibility and entered patient information into system.
- Answered incoming calls, scheduled appointments and filed medical records.
- Provided excellent customer service to patients and medical staff.
- Greeted and assisted patients with check-in procedures.
- Facilitated communication between patients and various departments and staff.
- Followed document protocols to safeguard confidentiality of patient records.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Responded to inquiries by directing calls to appropriate personnel.
- Engaged with patients to provide critical information.
- Helped address client complaints through timely corrective actions and appropriate referrals.
- Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
- Resolved customer complaints using established follow-up procedures.
- Delivered support to medical staff in completion of patient paperwork.
Patient Access Service Team Lead
Christus Spohn Hospital
01.2001 - 01.2007
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Providing excellent customer service by promptly answering patient inquiries.
- Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Trained new staff on hospital processes and procedures.
- Resolved patient billing issues in line with established guidelines.
- Educated patients on importance of preventive health care and insurance coverage.
- Addressed bad debts in line with set protocols.
- Verified patient insurance eligibility and entered patient information into system.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Trained new staff on filing, phone etiquette and other office duties.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
- Resolved customer complaints using established follow-up procedures.
Education
Physical Therapy Aide - Physical /Occupational Therapy
Penn Foster Career School
Scranton, PA05.2005
Skills
- Self-motivated, with powerful sense of personal responsibility
- Proven ability to learn quickly and adapt to new situations
- Worked well in team setting, providing support and guidance
- Worked effectively in fast-paced environments
- Managed time efficiently to complete all tasks within deadlines
- Demonstrated respect, friendliness, and willingness to help wherever needed
- Excellent communication skills, both verbal and written
- Passionate about learning and committed to continual improvement
- Proved successful working within tight deadlines and fast-paced environment
- Strengthened communication skills through regular interactions with others
- Organized and detail-oriented with strong work ethic
- Adaptable and proficient in learning new concepts quickly and efficiently
- Used critical thinking to break down problems, evaluate solutions and make decisions
- Identified issues, analyzed information and provided solutions to problems
- Participated in team projects, demonstrating ability to work collaboratively and effectively
- Cultivated interpersonal skills by building positive relationships with others
Timeline
Network Management Consultant
Blue Cross Blue Shield Of Texas
06.2009 - Current
Patient Access Service ER Team Lead
Christus Spohn Hospital Shoreline
01.2007 - 06.2008
Patient Access Service Team Lead
Christus Spohn Hospital
01.2001 - 01.2007
Physical Therapy Aide - Physical /Occupational Therapy
Penn Foster Career School
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