Carolina Cifuentes
Highlands Ranch,CO
Summary
Healthcare Manager proudly offering over 14 years of vast experience managing healthcare facilities and strong knowledge of medical procedures inpatient and outpatient, insurance verification and claims. Organized, detailed oriented and problem solving skills with excellent verbal and written communication skills.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Financial Clearance Unit Manager
H. Lee Moffitt Cancer Center
Tampa , Fl
05.2015 - Current
- Manages department of forty-five employees responsible for financially clearing 90% of over 37,000 biweekly appointments for Bone Marrow Transplant, CAR-T cell therapy, inpatient admissions, radiation therapy, high tech radiology and clinical trial patients.
- Manages team responsible of appealing claims denied for coordination of benefits, eligibility and authorizations. Increasing timely revenue for the organization.
- Assists in development and implementation of policies, procedures and regulations for unit operations.
- Ensures accurate collection and validation of data in Revenue Cycle Systems.
- Health insurance payment processes for commercial and government plans, including medical necessity and letters of agreement.
- Extensive knowledge of insurance verification and authorizations from all payers.
- Coordinates nursing with other services to promote continuity of total regimen of care.
- Recruits, hires and trains all staff, providing direct supervision, ongoing staff development and continuing education to employees.
- Identifies new areas of scientific research and provided internal training.
Supervisor
Tampa General Hospital
Tampa , FL
04.2012 - 05.2015
- Supervised and coordinated daily activities of a primary care and endocrinology ambulatory center. Including scheduling, staffing and coordinating workflow using independent judgment and following departmental procedures.
- Managed over 60 customer calls per day.
- Registered over 400 patients per week.
- Ensured non-funded patients are assessed and appropriate financial arrangements are established.
- Ensured provision of appropriate referrals for assistance to qualified patients.
- Coordinated training of new employees and assisted management in maintaining statistical information for departmental productivity reports.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Developed training, task and process guidelines and communicated clear and concise directions to employees.
Patient Access Specialist
Tampa General Hospital
Tampa , FL
12.2008 - 04.2012
- Gathers and records all necessary information in the process of generating an office account.
- Responsible for interviewing patients to confirm or obtain demographic and confidential clinical and financial information necessary to accurately and efficiently register, verify insurance eligibility and benefits, identify and collect patient copays, and identify those services that require an insurance authorization.
- Able to identify and explain forms that require patients' signature.
- Respond to patient concerns and inquiries professionally.
- Contact insurance companies for patient medical billing operations.
Medical Records Specialist
Tampa General Hospital
Tampa , FL
07.2008 - 12.2008
- Completed release of information requests including retrieving patient’s medical chart and returning chart, copying/scanning medical records accurately and correctly, according to requests, established standards of quality and productivity
- Mail copies or electronically deliver medical records
- Performed quality checks on all work to assure accuracy of the release, confidentiality and proper invoicing
- Processed fee approvals, invoice and transmit on a daily basis according to established procedures.
- Processed medical records requests from outside providers according to facility, state and federal law.
Education
Bachelor of Science - Health Care Management
Saint Leo University
Saint Leo, FL06.2012
Skills
- Proficient with Microsoft Word, Excel, Outlook and Power Point
- Epic Systems
- Adobe Systems Adobe Acrobat
- Strong communications skills, interpersonal, written and verbal
- Experience in dealing with people in high volume
- Competent benefit verifier using all resources for online verification, very knowledgeable of health insurance plans, benefits verification and authorizations
- Personable, hardworking, and reliable Detailed oriented and observant with strong organizational, time management skills
- Employee Training Program
- Citrix
Certification
Certified Revenue Cycle Representative, HFMA- 07/22/2022 to 07/22/2024
Timeline
Financial Clearance Unit Manager
H. Lee Moffitt Cancer Center
05.2015 - Current
Supervisor
Tampa General Hospital
04.2012 - 05.2015
Patient Access Specialist
Tampa General Hospital
12.2008 - 04.2012
Medical Records Specialist
Tampa General Hospital
07.2008 - 12.2008
Bachelor of Science - Health Care Management
Saint Leo University
Certified Revenue Cycle Representative, HFMA- 07/22/2022 to 07/22/2024
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