Clarissa DeGuzman
Freehold
Summary
Hardworking, highly motivated professional eager to lend combined knowledge and skills to enhance business performance. Operates well in both individual and team capacities, leveraging seasoned work ethic to quickly adapt to different processes and drive company objectives. Resourceful and results-driven with a passion for growth and efficiency to meet company needs and increase service value.
Overview
20
20
years of professional experience
Work History
WORK COMPENSATION SPECIALIST
Ivy Rehab Network
01.2022 - Current
- Developed an understanding of the insurance claims process and regulations for multiple states.
- Communicated with claimants in a professional manner to explain the claim process and obtain necessary documentation.
- Adhered to strict deadlines while managing multiple tasks efficiently.
- Maintained accurate records of all claims activities including calls, emails, letters sent and received.
- Provided excellent customer service by promptly responding to inquiries.
- Documented medical data in patient charts, facilitating accurate records.
- Conducted pre-authorizations and referrals to meet third-party insurer requirements.
- Communicated with insurance companies regarding authorization status updates or additional information needed for processing requests.
- Managed all aspects of authorization process, including verifying patient eligibility and benefits coverage for services rendered.
- Performed detailed data entry to ensure accuracy in tracking authorizations and denials.
- Monitored daily workflow queues while ensuring that all tasks are completed accurately and efficiently.
- Collaborated with providers to obtain required documentation for authorization requests.
- Cooperated in team relationships, fostering enthusiasm and maintaining mutual trust.
- Developed effective communication channels between departments within organization.
- Implemented best practices for organizing, cataloging, storing, archiving, and retrieving digital assets.
- Created custom databases to store, analyze, and report large sets of structured and unstructured data.
PATIENT COORDINATOR
Ivy Rehab Network
01.2019 - 01.2022
- Performed administrative duties such as filing documents or entering data into electronic health records systems.
- Maintained accurate records of patient information including medical histories, test results and treatments.
- Assisted patients with scheduling appointments, verifying insurance coverage and completing paperwork.
- Generated monthly statistical reports regarding clinic performance metrics such as wait times or no shows.
- Utilized strong organizational skills to manage multiple tasks simultaneously while maintaining focus on detail.
- Developed and implemented patient-centered strategies to ensure efficient workflow in the office.
- Coordinated care plans among multiple providers ensuring continuity of care throughout treatment process.
- Fostered a positive environment for both staff members and patients through effective problem solving techniques.
- Processed payments and maintained financial accounts for each patient accurately and efficiently.
ASSISTANT GENERAL MANAGER
Jersey Strong / WOW
01.2015 - 01.2019
- Recruited and hired associates to meet business needs and requirements.
- Collaborated with other departments to ensure successful store operations.
- Developed, implemented and monitored operational policies and procedures to ensure efficient workflow.
- Developed effective marketing plans to increase sales and profits while managing costs.
- Coordinated training programs for new hires; created detailed job descriptions based on roles and responsibilities.
- Mentored new associates to contribute to company's positive culture.
- Recruited, trained and supervised a team of 15+ employees in the sales department.
- Utilized strong interpersonal skills while interacting with customers, staff members and external stakeholders.
- Analyzed data to identify areas of improvement and develop strategies to increase sales.
DISPATCHER
GEM Ambulance
01.2006 - 11.2011
- Developed creative solutions for complex problems encountered during dispatch operations.
- Adhered to established protocols when responding to emergency calls.
- Updated incident reports following each call received or dispatched in accordance with departmental standards.
- Handled confidential information in a professional manner.
- Monitored radio transmissions to ensure appropriate responses to requests for service.
- Provided timely updates on emergency situations and patient conditions to medical staff.
- Assessed incoming callers' needs and determined the most appropriate course of action.
- Maintained accurate records of dispatched vehicles and personnel.
- Utilized a variety of software applications including database programs, mapping systems, and Microsoft Office suite.
Education
High School Diploma - Psychology
Kean University
Union, NJ, USHigh School - undefined
Raritan High School
Hazlet05-2001
Skills
- Compensation and Benefits Administration
- Staff Support
- Data Processing
- Microsoft Office
- Data Acquisition
- Administrative Support
- Efficient Data Entry
- Billing Procedures
- Spreadsheet Management
- Case management
- Patient education
- Documentation
Timeline
WORK COMPENSATION SPECIALIST
Ivy Rehab Network
01.2022 - Current
PATIENT COORDINATOR
Ivy Rehab Network
01.2019 - 01.2022
ASSISTANT GENERAL MANAGER
Jersey Strong / WOW
01.2015 - 01.2019
DISPATCHER
GEM Ambulance
01.2006 - 11.2011
High School - undefined
Raritan High School
High School Diploma - Psychology
Kean University