Claudia Hernandez
Oxnard,CA
Summary
Compassionate Patient Access Lead well-versed in performing diverse administrative functions for patient care with high degree of diplomacy and problem-solving acumen. Positive and upbeat team player with good communication and time management abilities. Demonstrated extreme attention to detail with accuracy of medical records.
Overview
27
27
years of professional experience
Work History
Patient Access Specialist
St John's Regional Medical Center
Oxnard , CA
01.2024 - 07.2024
- Greeted patients and visitors in person or on the telephone; answered inquiries, provided directions and instructions.
- Resolved issues related to registration process including eligibility verification and authorization problems.
- Performed data entry tasks associated with registrations such as entering demographic data into system database.
- Verified patient insurance coverage, collected copays and other payments, processed credit card transactions.
- Assisted with scheduling appointments, pre-registration activities, verifying demographics and insurance information.
- Provided assistance with answering questions related to billing processes or assisting customers with payment plans.
- Worked closely with departmental staff members in order to ensure proper coordination of care across multiple departments.
- Responded to patient concerns and inquiries professionally and efficiently.
- Obtained necessary signatures for privacy laws and consent for treatment.
- Applied HIPAA privacy and security regulations while handling patient information.
- Interviewed patients upon entrance to hospital, gathered appropriate information and entered data into electronic system.
- Processed patient responsibility estimate determined by insurance at pre-registration.
- Called insurance companies and verified patient coverage.
- Obtained health, financial and religious information from patients at time of admission.
- Organized and maintained records by updating and obtaining both personal and financial information from patients.
- Assembled registration paperwork and placed identification bands on patient.
- Verified demographics and insurance information to register patients in computer system.
- Communicated financial obligations to patients and collected fees at time of service.
- Utilized hospital systems to update patient records, ensuring accuracy and completeness.
- Managed patient check-in process, ensuring accurate data entry of personal and insurance information.
- Processed insurance verifications and authorizations to ensure coverage of services.
- Coordinated scheduling of appointments across multiple departments to optimize patient care.
- Reviewed eligibility responses to assess patient benefit level and prepare estimates.
- Collaborated with insurance companies to resolve billing discrepancies and pre-certification issues.
- Coordinated with clinical staff to manage patient flow, reducing wait times and improving satisfaction.
- Kept patient appointments on schedule by notifying providers of patients' arrival and reviewing service delivery compared to schedule.
- Collaborated with clinical and administrative staff to meet patient needs.
- Verified documentation methodically to avoid critical errors impacting care delivery and payments for services.
Lead Patient Access Representative
Guidehouse
Ventura
03.2021 - 07.2024
- Served as a resource for Patient Access Representatives, providing guidance and assistance with complex registration issues.
- Performed daily audits of patient accounts to ensure accuracy of information entered into system.
- Developed and maintained relationships with physicians, hospital staff, insurance companies, and other healthcare organizations to facilitate the registration process.
- Ensured compliance with government regulations regarding HIPAA privacy laws, medical record release policies.
- Trained new hires on proper patient access protocols, procedures and customer service skills.
- Resolved escalated customer complaints in a timely manner while maintaining professional standards of conduct.
- Provided support to other departments when needed during peak times or special projects.
- Facilitated communication between clinical teams and financial counselors regarding payment plans or financial aid options.
- Obtained necessary signatures for privacy laws and consent for treatment.
- Organized and maintained records by updating and obtaining both personal and financial information from patients.
- Applied HIPAA privacy and security regulations while handling patient information.
- Facilitated patient registration, verifying all required documentation is collected and filed properly.
- Coordinated with clinical staff to manage patient flow, reducing wait times and improving satisfaction.
- Utilized hospital systems to update patient records, ensuring accuracy and completeness.
- Prepared daily reports on registration activities, highlighting areas for improvement.
- Assisted in the implementation of new technologies and processes to improve patient access services.
- Contributed to team meetings, sharing insights and strategies for improving patient access services.
- Supported emergency department registration during peak times, ensuring rapid patient processing.
- Participated in training sessions to stay updated on healthcare policies and registration software.
- Received patient inquiries or complaints and directed to appropriate medical staff members.
- Documented patient counters in hospital system and initiated follow-up actions.
- Reported liabilities and risk management concerns to supervisor for review.
- Cultivated positive relationships with patients to help facility meet satisfaction scores and patients obtain best possible care.
Patient Access Coordinator
Community Memorial Health System
Ventura
02.2016 - 03.2021
- Ensured that all necessary documentation was completed accurately and submitted in a timely manner.
- Maintained accurate patient records, including registration data in computer systems.
- Adhered to HIPAA guidelines when handling confidential patient information.
- Greeted patients, verified patient identification and collected demographic information.
- Coordinated with clinical staff to ensure timely completion of registration process.
- Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations.
- Obtained necessary signatures for privacy laws and consent for treatment.
- Verified demographics and insurance information to register patients in computer system.
- Applied HIPAA privacy and security regulations while handling patient information.
- Assembled registration paperwork and placed identification bands on patient.
- Communicated financial obligations to patients and collected fees at time of service.
- Registered patients by completing face-to-face interviews to obtain demographic, insurance, and medical information.
- Processed patient co-pays, deductibles, and other payments, ensuring accurate financial records.
- Managed patient check-in process, ensuring accurate data entry of personal and insurance information.
- Participated in training sessions to stay updated on healthcare policies and registration software.
- Reviewed eligibility responses to assess patient benefit level and prepare estimates.
- Explained various admission forms and policies, acquiring signatures for consent.
- Conducted financial counseling for patients, explaining payment options and assistance programs.
- Guided patients through the completion of consent and other required medical forms.
- Facilitated patient registration, verifying all required documentation is collected and filed properly.
- Completed registration procedures for patients, expertly inputting information to meet provider, facility and legal requirements.
- Verified patients' insurance and payment methods during admissions or check-in processes.
- Initiated application processes to add patients to assistance programs at bedside and followed through until completion.
- Screened patients for eligibility for state, local and federal assistance programs.
Authorization Coordinator
Option Care
Ventura , CA
07.2016 - 03.2018
- Analyzed data from various sources to ensure accuracy of authorizations.
- Performed administrative duties such as filing, copying, scanning, faxing.
- Identified discrepancies in authorization requests, reported them to management, and took corrective action as needed.
- Researched information as necessary to resolve customer inquiries or issues with authorizations.
- Maintained accurate records of all authorizations in the system.
- Collaborated with other departments within the organization to ensure timely completion of authorizations.
- Processed incoming authorization requests and updated customer accounts accordingly.
Customer Service Representative III
Anthem Blue Cross
Newbury Park , CA
11.1997 - 03.2015
- Maintained a high level of professionalism when dealing with difficult customers.
- Provided exceptional customer service to ensure customer satisfaction.
- Answered customer inquiries and provided accurate information regarding products and services.
- Provided accurate information about products and services to customers.
- Answered customer inquiries via phone, email, and chat.
- Maintained detailed records of customer interactions, transactions and comments for future reference.
- Asked probing questions to determine service needs and accurately input information into electronic systems.
- Informed customers about billing procedures, processed payments, and provided payment option setup assistance.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
- Answered inbound calls, chats and emails to facilitate customer service.
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
- Utilized job-related software to prepare change of address records and issue service discontinuance orders.
- Presented existing and prospective customers with valuable service or product information to aid in decision-making.
- Engaged in conversation with customers to understand needs, resolve issues and answer product questions.
- Prevented key account losses by researching discrepancies and correcting problems.
- Coordinated with internal teams to ensure timely and successful delivery of solutions according to client needs.
- Kept records of customer interactions or transactions, thoroughly recording details of inquiries.
- Led on- and off-site customer support teams across multiple time zones.
- Adjusted bills and refunded money to resolve customers' service or billing complaints.
- Collected deposits or payments and arranged for billing.
Education
Bachelor of Science - Health Administration
Charter College
Oxnard, CA03-2019
Skills
- Eligibility Determination
- Insurance Verification
- Information Collection
- Patient interviewing
- Front Desk Operations
- Patient Registration
- Authorization verification
- Co-payment collection
- HIPAA Compliance
- Patient Scheduling
- Insurance information collection
Languages
Spanish
Native/ Bilingual
Timeline
Patient Access Specialist
St John's Regional Medical Center
01.2024 - 07.2024
Lead Patient Access Representative
Guidehouse
03.2021 - 07.2024
Authorization Coordinator
Option Care
07.2016 - 03.2018
Patient Access Coordinator
Community Memorial Health System
02.2016 - 03.2021
Customer Service Representative III
Anthem Blue Cross
11.1997 - 03.2015
Bachelor of Science - Health Administration
Charter College
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