CAROLINA MARTINEZ
Rockville Centre,NY
Summary
Detail-oriented Professional with over 20 years of experience in patient registration, billing compliance, and hospital operations. I also have some experience in human resources for a home care facility. I hold a Bachelor's degree in Business Administration/Health Management and plan to pursue a Master's in Health Law & Policy. I am seeking to expand my knowledge in law firms, home care, and financial departments while contributing to efficient delivery and quality care.
Overview
15
15
years of professional experience
Work History
ED Registrar
St. Francis Hospital & Heart Center
01.2023 - Current
- Manage patient intake, insurance verification, and data entry into EHR systems for accurate documentation and compliance
- Provide clear communication on hospital policies, co-pays, and billing procedures
- Assist in consent form processing, eligibility verification, and coordination with clinical staff
- Ensure HIPAA compliance and patient confidentiality
- Registration for 80 patients at a day handling patient inquiries.
- Developed strong rapport with patients and families through active listening, empathetic communication, and providing clear explanations of medical conditions or treatment plans.
- Completed administrative patient intakes with case histories, insurance information and mandated forms.
Hospital Care Investigator
QHC for New York Health and Hospitals
01.2018 - Current
- Conduct financial investigations into billing discrepancies and fraud within healthcare claims.
- Collaborate with finance and billing teams to resolve payment issues and ensure proper reimbursement.
- Review and audit patient billing records, insurance claims, and financial transactions to detect potential fraud and overpaid or underpaid issues, working closely with clinical and administrative teams.
- Perform financial audits and investigations into specific patient care incidents or cases to ensure compliance with Medicare, Medicaid, and private payer billing requirements.
- Analyze patterns in denied claims or incorrect billing submissions, create actionable reports, and work with relevant departments to implement corrective actions.
Human Resources Supervisor
Link Home Care
01.2017 - 01.2018
- Managed HR functions, including onboarding, training, payroll, and compliance with NYS DOH requirements
- Assisted with the timely submission of payroll data and benefits and maintained employee records
- Ensured adherence to federal and state labor laws and assisted with employee performance management
- Follow-up claims and Medicaid payments
- Supervised team follow-ups
- Preparing training and orientation recruitment policies for more than 20 employees a month.
Manager Claim Specialist
Women's Healthcare PC
01.2010 - 01.2017
- Patient Collection, self-pay accounts manager /Authorizations /Insurances appeals /claims follow-up, and payment posting
- Spanish to English translator
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
- Maintained a professional, organized, and safe environment for employees and patrons.
- It develops and maintains relationships with customers and suppliers through account development.
Education
Master of Health Law Policy -
Hofstra University
Long Island, NY01.2025
Bachelor of Science - Health Administration / Business Management
Monroe University
New York, NY01.2024
Associate of Science - Business Management
Long Island Business Institute
Flushing, NY01.2010
Skills
- Compassionate patient care
- Time management
- Reliable
- Healthcare ethics
- Language proficiency
- Problem-solving abilities
- Multitasking
- Collaboration and teamwork
- HIPAA compliance
- Organizational skills
- Flexible schedule
Accomplishments
Hippa certification
3.8 GPA
epic user training certification
Languages
Spanish
Native or Bilingual
Timeline
ED Registrar
St. Francis Hospital & Heart Center
01.2023 - Current
Hospital Care Investigator
QHC for New York Health and Hospitals
01.2018 - Current
Human Resources Supervisor
Link Home Care
01.2017 - 01.2018
Manager Claim Specialist
Women's Healthcare PC
01.2010 - 01.2017
Bachelor of Science - Health Administration / Business Management
Monroe University
Associate of Science - Business Management
Long Island Business Institute
Master of Health Law Policy -
Hofstra University
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