Cynthia Williams
Healthcare Patient Service Representative
Hemet,CA
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
9
9
years of professional experience
8
8
years of post-secondary education
Work History
Client Movement Specialist
ACES (Comprehensive Educational Services, Inc.)
San Diego, California
10.2021 - Current
- Review and analyze referrals for pre-authorization, concurrent review, and case management
- Familiar with following payors- (Tricare, Kaiser HI, UHA, Partnership HP of CA, Holman SCA-ESSC, Cal Optima, Premera Blue Cross, Blue Shield (Magellan, United Healthcare (United Behavioral Health), First Choice)
- Coordinate onboarding process for new clients, including collecting necessary intake information and required documentation
- Software: Microsoft Office, Central Reach and Ascend, SharePoint and Microsoft Teams
- Verify benefits and eligibility for clients either thru payors portal or via phone
- Case management duties assisted Program Manager with client cases
- Manage documents and data entry, including creating and maintaining data sheets, client files, updating patients' profile
- Communicate and coordinate work efforts with team members via phone, email and in-person
- Assist clinical team with preliminary intake documents
- Provide general office support for Welcome Center as needed
- Coordinate onboarding process for new clients, including collecting necessary intake information and required documentation
- Submit over 30 Pre-authorization requests a day as well as upload continued service authorization approvals
- Provide excellent customer service
- Outbound calls to parents regarding care for their children.
- Interacted with other members of team in staff and IEP meetings to discuss student progress and adjust plans to meet changing demands.
- Cultivated interpersonal skills by building positive relationships with others.
- Skilled at working independently and collaboratively in team environment.
- Worked well in team setting, providing support and guidance.
- Identified issues, analyzed information and provided solutions to problems.
- Assisted with day-to-day operations, working efficiently and productively with all team members
- Proven ability to learn quickly and adapt to new situations
- Demonstrated strong organizational and time management skills while managing multiple projects
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution
Site Specialist
Curative
Indio, California
03.2021 - 07.2021
- Setting up and preparing kiosk for testing
- Provide customer service
- Checking 50-100 people in for appointment and directing walk ins
- Tracking and reporting key data points
- Participate in training/retraining and continuing education programs as necessary
- Comply with all designated safety policies and procedures in work area, including use of applicable protective equipment when necessary to prevent exposure to potentially infectious agents
- Understand and comply with applicable federal, state and local laws and company policies
- Adheres to quality assurance procedures
- Knowledge of and maintain all HIPAA standards
- Performs other related duties as necessary
- Usage Apple and PC laptops, barcode scanners, Google Drive, Zoom, Notion, Metabase, etc.
- Tracked and documented customer interactions in customer relationship management system to maintain accurate records.
- Maintained records and logs of work performed and materials and equipment used.
- Broke down and evaluated user problems, using test scripts, personal expertise, and probing questions.
- Resolved issues between employees and customers using company policies
Administrative Assistant-Contract Position
Global Medical Detox
Menifee, CA
05.2019 - 11.2020
- Develops, coordinates and prepares departmental reports
- Type correspondences, reports, memos, forms, labels, documents
- Verifies insurance benefits for new admissions
- Communicates results with supervisor and Intake team
- Greets all patients and visitors arriving in admission office or nurses' station; answers telephones, routes callers, take messages and provides routine information to caller's aids in day o-day administration of department; maintains office supplies
- Maintains patient charts, MD consult binder, Pt identification binder, consent binder, daily census, and census board
- Assisted Supervisor in creating and submitting TARS (Treatment Authorization Request) to either, Medi-Cal or other commercial insurances (Medicare, United Health Group, Aetna, and Blue Cross)
- Enter patient's admission, discharges, room changes and accommodation codes in AS400
- Assistant to Project Manager and Nurse Supervisor with daily schedule and payroll
- Answer calls for Intake, Unit Secretary, & Counselors.
- Executed record filing system to improve document organization and management.
- Sorted and distributed office mail and recorded incoming shipments for corporate records.
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Assisted coworkers and staff members with special tasks on daily basis.
- Sorted and distributed office mail and recorded incoming shipments for corporate records
- Developed strategies to streamline and improve office procedures
- Liaised between clients and vendors and maintained effective lines of communication
- Identified and recommended changes to existing processes to improve accuracy, efficiency, and quality service
- Managed filing system, entered data and completed other clerical tasks
- Completed forms, reports, logs, and records to quickly handle all documentation for human resources
Patient Service Representative
Neighborhood Healthcare
Temecula, CA
06.2018 - 08.2019
- Answers 50-100 telephone calls promptly and in polite and professional manner
- Obtain and enter accurate demographic information into ECW {E Clinical Works}, (address, telephone number, name of insurance)
- Verified medical insurance through Molina, IEHP, and Medi-Cal web portals
- Educate patients on available programs offered through Neighborhood Healthcare
- Accurately schedule and confirm patient appointments using ECW software according to established guidelines and reschedule as necessary
- Answers questions and offer other information, as requested, to provide patient-focused service and positive impression of organization
- Monitor provider schedules for openings to ensure maximum utilization of all available appointments
- Work in collaboration with clinic staff to identify and resolve patient issues or concerns
- Direct calls to other departments including pharmacies as needed
- Use sound judgment in handling calls, especially with upset patients.
- Assisted patients in filling out check-in and payment paperwork.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Handled customer service inquiries in person, via telephone and through email.
- Verified insurance eligibility and coverage for patients.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Developed and implemented customer service policies and procedures.
- Managed patient registration process, confirming data accuracy and completeness.
- Organized patient records and database to facilitate information storage and retrieval.
- Worked with patients to ascertain issues and make referrals to appropriate specialists.
- Used E Clinical Works to schedule appointments
- Filed and maintained patient records in accordance with HIPAA regulations
- Verified insurance eligibility and coverage for patients
- Managed patient registration process, confirming data accuracy and completeness
Patient Services Specialist
Scripps Green Hospital
La Jolla , CA
05.2015 - 06.2018
- Provided strong and high-level customer service to over 200+ patients during work shift
- Paged medical staff and patients using public-address system in courteous and understandable manner
- Provided strong and high-level customer service to over 200+ patients during work shift
- Knowledge of central communications point for all in-house emergencies; i.e., Code Red & Code Blue
- Immediately answer emergency line, listen to details to identify nature of problem and respond appropriately in accordance with established procedures.
- Initiated emergency response as necessary and legibly document pertinent details.
- Worked with software programs: D-Base, Eclipse, PMA, Epic and Outlook and Next Gen.
- Inputted accurate patient insurance, billing and payment information in Epic Software.
- Demonstrated exceptional customer service to foster welcoming and professional environment for patients.
- Called patient to confirm appointment and prepared paperwork prior to visit to expedite check-in process.
- Built and maintained positive working relationships with patients and staff.
- Handled customer service inquiries in person, via telephone and through email.
Education
Bachelor's Degree - Healthcare Administration
Southern New Hampshire University
Manchester, NH 03.2014 - 08.2019
Associate of Applied Science - Medical Insurance Billing
Grossmont College
El Cajon, CA 05.2007 - 12.2009
Skills
HIPAAundefined
Timeline
Client Movement Specialist
ACES (Comprehensive Educational Services, Inc.)
10.2021 - Current
Site Specialist
Curative
03.2021 - 07.2021
Administrative Assistant-Contract Position
Global Medical Detox
05.2019 - 11.2020
Patient Service Representative
Neighborhood Healthcare
06.2018 - 08.2019
Patient Services Specialist
Scripps Green Hospital
05.2015 - 06.2018
Bachelor's Degree - Healthcare Administration
Southern New Hampshire University
03.2014 - 08.2019
Associate of Applied Science - Medical Insurance Billing
Grossmont College
05.2007 - 12.2009
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