Carmen Escanuela
MILPITAS
Summary
Dynamic and empathetic professional with a proven track record at Regional Medical Center of San Jose, excelling in customer service and HIPAA compliance. Leveraged strong empathy and attention to detail to enhance patient satisfaction and streamline insurance verification processes. Achieved notable improvements in efficiency and patient trust through collaborative teamwork and innovative problem-solving.
Overview
29
29
years of professional experience
Work History
Patient Access Representative
Regional Medical Center Of San Jose
12.2004 - Current
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Adapted quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.
- Provided excellent customer service through active listening skills, understanding patient needs, and offering tailored solutions where applicable.
- Contributed to a positive work environment by fostering strong relationships among colleagues, promoting teamwork, and sharing best practices.
- Managed challenging situations effectively by remaining calm under pressure while resolving conflicts or addressing dissatisfied patients professionally.
- Enhanced overall patient experience with empathetic communication and thorough explanations of insurance benefits and coverage.
- Facilitated smooth billing processes by verifying insurance eligibility, obtaining authorizations, and accurately entering claim details into the system.
- Maintained accurate patient records, contributing to a well-organized database for seamless information access across departments.
- Streamlined patient registration processes by implementing efficient data collection methods and reducing wait times.
- Developed proficiency in various healthcare software programs for accurate documentation of patient encounters and streamlined workflows within the department.
- Improved patient satisfaction scores by actively addressing concerns and providing prompt assistance during the check-in process.
- Assisted with administrative tasks such as filing, data entry, and report generation to support streamlined office operations.
- Supported medical staff by coordinating diagnostic testing appointments, lab results retrieval, and necessary referrals in a timely manner.
- Collaborated with healthcare providers to ensure timely appointment scheduling and coordinated follow-up care for patients'' needs.
- Enhanced departmental collaboration by regularly liaising with medical, nursing, and administrative staff on pertinent patient matters.
- Trained new hires on department procedures, policies, and software systems, ensuring consistent quality service delivery from all team members.
- Achieved high levels of accuracy in patient data entry, minimizing errors and enhancing record reliability.
- Improved patient satisfaction by efficiently managing registration and intake processes.
- Increased patient trust and satisfaction, delivering empathetic support and guidance throughout their visit.
- Verified patient insurance eligibility and entered patient information into system.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Followed document protocols to safeguard confidentiality of patient records.
- Facilitated communication between patients and various departments and staff.
- 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.
Financial Counselor
San Jose Medical Center
07.1996 - 12.2004
- Worked with clients to develop personal recommendations for improvement of financial circumstances, reducing debt and increasing income.
- Cultivated a positive, non-judgmental environment for clients to openly discuss their financial challenges and concerns.
- Increased client confidence in managing personal finances by providing tools and resources for long-term success.
- Conducted interviews with patients and family members and answered questions regarding insurance benefits.
- Contacted insurance providers to obtain key information regarding patient benefits and to submit documentation for accounts.
- Strengthened client understanding of complex financial concepts using clear explanations and real-life examples.
- Liaised between patient, doctor and insurance provider to smooth claims processes.
- Implemented crisis intervention strategies when necessary, connecting clients with appropriate emergency resources during times of severe financial hardship.
- Identified healthcare resources and programs for patients unable to meet financial obligations.
- Increased patient confidence in the billing process by providing clear explanations of insurance benefits and coverage limitations.
- Enhanced patient satisfaction by effectively explaining financial options and answering billing inquiries.
- Negotiated payment plans with patients, maintaining a high rate of successful payments.
- Provided compassionate assistance to financially challenged patients, identifying potential sources of funding or discounts when applicable.
- Reduced hospital bad debt through proactive communication with patients about their financial responsibilities.
- Facilitated timely resolution of outstanding balances by connecting patients with appropriate resources and support.
- Implemented patient follow-up system to address billing questions, leading to decrease in patient complaints.
- Coordinated with external collection agencies on delinquent accounts, ensuring sensitive handling of patient financial situations.
- Improved patient satisfaction by offering comprehensive financial counseling services, ensuring clarity on billing and insurance processes.
- Trained new staff on patient financial services best practices, elevating overall performance of financial counseling team.
- Enhanced patient understanding and reduced financial stress with clear explanations of complex insurance benefits and coverage.
- Contributed to departmental goals by consistently meeting or exceeding established performance metrics.
- Streamlined insurance verification processes for increased efficiency and reduced errors.
- Negotiated payment plans and settlements with patients, improving cash flow and reducing accounts receivable aging.
- Educated patients on available financial assistance programs, guiding them through application processes when needed.
- Educated patients on available financial assistance programs, increasing their access to necessary healthcare services.
- Collaborated with healthcare providers to ensure accurate billing codes, reducing claim denials and improving reimbursement rates.
- Collaborated with medical staff to ensure accurate billing codes and minimize claim denials.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Delivered support to medical staff in completion of patient paperwork.
Education
High School Diploma -
Adrian Wilcox High School
Santa Clara, CA06-1991
Skills
- Customer service
- Insurance verification
- HIPAA compliance
- Registration and admissions
- Multitasking and organization
- Phone and email etiquette
- Medical terminology
- Strong empathy
- Attention to detail
- Team collaboration
- Calm and effective under pressure
- Punctual and hardworking
Languages
Spanish
Native or Bilingual
Timeline
Patient Access Representative
Regional Medical Center Of San Jose
12.2004 - Current
Financial Counselor
San Jose Medical Center
07.1996 - 12.2004
High School Diploma -
Adrian Wilcox High School
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