Carolyn Lee Shue Ling
Rochester,NY
Overview
10
10
years of professional experience
Work History
Patient Registration Associate II
Highland Hospital Women's Health
08.2025 - Current
- Welcomed patients with professionalism, verified demographic and insurance details, and accurately input all data into hospital electronic health record system.
- Maintained patient information in electronic medical records to ensure accuracy and accessibility. Sorted and routed correspondence for effective communication between patients and providers. Processed prescription refills and referrals to support timely patient care. Managed patient messages through systems like MyChart to enhance response efficiency.
- Scheduled appointments and coordinated patient visits to enhance operational efficiency. Managed patient flow to minimize wait times and improve service delivery. Edited registration errors and completed missing data to ensure accurate patient records.
- Facilitated charge capture and entry processes to ensure accurate billing. Assisted with charge reconciliation to resolve discrepancies efficiently. Evaluated patient eligibility for discount fee schedules, optimizing financial assistance.
- Served as front-line problem solver, addressing customer complaints effectively. Utilized service recovery techniques to restore customer satisfaction and loyalty.
- staff support and training: may coordinate duties of other staff and assist in training patient registration associates or less experienced personnel.
- clinical support (with verification): may execute basic clinical support tasks such as escorting patients, collecting height and weight, and obtaining vital signs once competencies are validated by clinical staff.
- Identifies and compiles all relevant printed materials for patients, including patient rights, responsibilities, HIPAA privacy act notifications, and release of information forms.
- experience working in hospital patient registration department physician office environment healthcare insurance firm.
- expertise in various EMR/EHR systems including Epic, Officemate, Practice Fusion, among others.
Front Office Verification Specialist
Sager Eye Care Center
11.2021 - 07.2025
- Organize and coordinate patient appointments efficiently.
- Greeted patients at reception and facilitated smooth check-in and check-out processes. Assisted patients with inquiries and provided necessary information at front desk. Managed appointment scheduling and coordinated patient flow efficiently. Maintained organized reception area to enhance overall patient experience.
- execute routine data entry functions
- respond to inbound telephone inquiries and initiate outbound calls as needed
- Confirm patients' coverage eligibility and initiate prior authorizations & referrals via Availity website.
- knowledge of EMR system through OfficeMate and proficiency in adding patient information and submitting prescriptions.
- coordinate with sales and brand representatives regarding appointment scheduling and sample requests for eye and contact solutions
- continue execution of structured filing systems
- perform all other office tasks including auto-refracting patients, capturing images, and conducting eye tests based on office visits
- Supported opticians with administrative tasks, including inventory management and glasses dispensing. Entered lab job tickets and invoices to maintain accurate records.
- responsible for procuring general office inventory and supplies.
- manage subpoenas upon request.
- facilitates basic services when needed and acts as intermediary for operational issues.
Administrative Assistant (Temporary Position)
Foundation of Sickle Cell Disease Research
08.2021 - 10.2021
- Organize and coordinate appointments and events for administrative team.
- greet and assist patients at front desk
- handle incoming telephone calls
- maintain organized filing systems (in-office or virtual)
- execute additional office responsibilities
- draft communications and other official documents
- execute routine data entry tasks related to electronic health records
- execute routine data entry tasks related to grant(s)
- telecommuting
Fulfillment Online Personnel
Walmart
02.2021 - 08.2021
- Provide customer service by acknowledging the customer; identifying customer needs; assisting with purchasing decisions; locating merchandise; resolving customer issues and concerns; and promoting products and services, while maintaining a safe shopping environment.
- Maintain merchandise presentation by stocking and rotating merchandise; removing damaged or out- of-date goods; setting up, cleaning, and organizing product displays; signing and pricing merchandise appropriately; inspecting merchandise to ensure a fresh and clean presentation, and securing fragile and high-shrink merchandise.
Grievance and Appeals Analyst
Cigna
04.2019 - 02.2021
- Precisely identify and record customer complaints based on notes gathered from customer service correspondence and review of recorded interactions
- Leverage knowledge of program processes and systems to investigate assigned grievance cases thoroughly, identifying root causes of received complaints and determining suitable resolutions for each situation.
- Communicate identified resolution to customer or representative through written or verbal methods
- Determine and record resolution and root cause for assigned grievances.
- Report identified trends in complaints and root causes for management escalation
- Compile reports as requested by management.
- Exhibit positive demeanor while ensuring technical accuracy and adherence to company policies.
- Comprehend CMS guidance and ensure communication aligns with CMS standards.
- Uphold HIPAA regulations within immediate environment.
- Developed detailed and concise documentation pertaining to member records.
- Recognizes necessity for outbound calls to validate information and addresses, while executing member outreach
- Adhere to and comply with all regulations, policies, work procedures, and instructions.
- React swiftly to correspondence and faxes.
- Effectively managed remote work environment to maintain productivity and communication. Utilized digital collaboration tools to enhance team engagement and project tracking. Developed strategies for optimizing workflow in a remote setting. Conducted regular virtual meetings to align team objectives and progress updates.
Document Processing Analyst
Cigna
10.2018 - 04.2019
- Ensured proper processing of incoming mail in accordance with NH/CMS and NH/ARGUS compliance standards. Proactively communicated findings to relevant stakeholders for timely resolution.
- Streamlines communication regarding updates on changes and adjustments to rules, policies, and responsibilities as needed.
- Demonstrated positive demeanor while ensuring technical accuracy and adherence to company policies. Ensured compliance with CMS guidance by mailing applicable exhibits as required. Maintained HIPAA regulations within immediate environment to safeguard sensitive information.
- accountable for precise and comprehensive notations regarding member records.
- manages outbound calls for validation of information and/or addresses.
- Adhere to and comply with all regulations, policies, work procedures, and instructions.
Mentor
Envision Healthcare
05.2018 - 09.2018
- Ensured compliance with CMS regulations in incoming mail processing. Proactively communicated findings to relevant stakeholders for immediate action.
- Proactively communicates updates regarding changes and adjustments to rules, policies, and responsibilities as necessary.
- understands CMS guidance and ensures applicable exhibits are mailed per CMS guidance.
- Monitor adherence to HIPAA regulations within immediate environment.
- accountable for concise and detailed documentation regarding member records.
- manages outbound calls to verify information and/or addresses.
- Revise account information including billing options and updates to address or phone numbers.
- Instruct beneficiaries on plan functionality, including benefits, cost sharing, and coverage levels.
- support CSRs in resolving problematic situations or client complaints
- serve as communication link between CSRs and supervisors.
- Oversee daily operations to ensure achievement of all operational metrics effectively and efficiently.
- monitoring cms skill reports to ensure employee adherence to schedules and proper aux statuses
Member Service Advocate (CSR)
Envision Healthcare
10.2016 - 05.2018
- Handle inbound calls from beneficiaries enrolled in Part D and commercial insurance program.
- Facilitate beneficiaries in updating account information, delivering plan details, and addressing issues related to plan utilization.
- Revise account information including billing options and modifications to address or phone numbers.
- Researched premium billing discrepancies and processed prescription claims. Educated beneficiaries on functions of Part D plan, including benefits, cost-sharing, and coverage levels.
- Submitted mail requests for beneficiaries, including ID cards and formularies. Verified coverage of medicines on formulary, confirming tier and copay levels. Provided detailed explanations for drugs not covered under the plan.
- Support pharmacies in resolving prescription denials and errors while verifying benefits.
- advise providers on obtaining prior authorizations for prescribed medications with restrictions such as step therapy and quantity limits
- Revise account information including billing options and modifications to address or phone numbers.
- create concise, detailed notations pertaining to member records.
Education
Modern Studies
Holy Faith Convent
Trinidad And TobagoHuman Resources Training
Australian Institute of Business
Trinidad And Tobago Skills
patient privacy
Professional conduct
Insurance verification processes
healthcare terminology
Calendar management
Accuracy measurement
Healthcare sector
Interpersonal skills
Data entry
patient communication
Electronic record management
multitasking skills
Effective communication
clear communication skills
Adaptability skills
verbal communication
Strategic decision-making
Patient training
Information documentation
Insurance verification
health coverage
insurance approvals
Administrative support
patient registration
Record-keeping
Timeline
Patient Registration Associate II
Highland Hospital Women's Health
08.2025 - Current
Front Office Verification Specialist
Sager Eye Care Center
11.2021 - 07.2025
Administrative Assistant (Temporary Position)
Foundation of Sickle Cell Disease Research
08.2021 - 10.2021
Fulfillment Online Personnel
Walmart
02.2021 - 08.2021
Grievance and Appeals Analyst
Cigna
04.2019 - 02.2021
Document Processing Analyst
Cigna
10.2018 - 04.2019
Mentor
Envision Healthcare
05.2018 - 09.2018
Member Service Advocate (CSR)
Envision Healthcare
10.2016 - 05.2018
Modern Studies
Holy Faith Convent
Human Resources Training
Australian Institute of Business