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
HIPAAEpic
Customer service Experience
Microsoft Office
Live chatEclipseCentral Reach experienceMedical recordsMedical codingMedical terminologyScheduling (Pediatrics, BH, Surgery and General Medicine)
Records Management
Insurance and authorization procurement experience
Submitting for Preauthorization onboarding process for new clients, including collecting necessary intake information and Referrals
Troubleshooting
Excellent Communication
Customer Service
Multitasking
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