Summary
Overview
Work History
Education
Skills
Timeline
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Cynthia L. Williams

Hemet,CA

Summary

Graduate of Health Care Administration with a passion for developing compassionate and caring rapport working in the healthcare field. Offers an entrepreneurial attitude with proven abilities in referral authorization, insurance verification and patient service. Proficient in the ongoing assessment and authorization of behavioral analysis services for individuals with autism. Flexible and hard working team player focused on boosting productivity and performance with conscientious and detailed-oriented approaches.

Overview

10
10
years of professional experience

Work History

Referral Coordinator-Data Management

Aces Aba, LLC
10.2021 - 02.2024
  • Evaluate and process referrals for pre-authorization, concurrent review, and case management.
  • Assess incoming referrals and determine appropriate authorization process.
  • Facilitate onboarding of new clients by collecting intake information and documentation.
  • Managed filing and processed medical documents. retrieved and stored information on an internal database..
  • Monitored and managed information systems for accuracy and stability.
  • Protected the privacy of over 200 patients by following HIPAA regulations.

Member Service Coordinator-Contracted Position

Curative Inc.
03.2021 - 09.2021
  • Handle various tasks including enrollment, claims processing, benefit interpretation
  • Assisted with Front desk administrative duties which included patient registration, scheduling and updating EHRs
  • Handle various tasks including enrollment, claims processing
  • Contribute to seamless functioning of call center and ensure member satisfaction
  • Documented patients EHR and to the California Board of Health with the patients Covid shots.

Administrative Assistant (Contracted)

Global Medical Detox
01.2020 - 11.2020
  • Managed high-volume phone calls and emails, providing prompt assistance and resolution to member inquiries while adhering to HIPAA guidelines
  • Interpreted PPO, HMO and Medi-Cal along with various insurance plans, assisted with enrollment, claims processing, benefit interpretation, and referrals for medical services and prescriptions
  • Maintained an updated member database for efficiency and accuracy in service delivery
  • Handled various tasks including intake, admissions, discharges
  • Along with claims processing, benefit interpretation, ensured seamless call center operations and member satisfaction
  • Explanation of Benefits (EOBs), provider selection, and referrals/authorizations for medical services and prescriptions with precision and effectiveness.

Call Center Representative

Neighborhood Healthcare
06.2018 - 08.2019
  • Answered 50-100 telephone calls per day promptly and in a polite and professional manner
  • Educate patients on available programs offered through Neighborhood Healthcare, including MyCare Portal
  • Use sound judgment in handling calls, especially with upset patients
  • Monitor Provider schedules for openings to ensure maximum utilization of all available appointments
  • Worked in collaboration with clinic staff to identify and resolve patient issues or concerns
  • Obtain and enter accurate demographic information into ECW-{Electroninc Medical Record software} (address, telephone number, name of insurance)
  • Accurately schedule and confirm patient appointments according to established guidelines and reschedule as necessary
  • Direct calls to other departments including pharmacies as needed
  • Understanding when complex customer inquiries or complaints need to be transferred to the Supervisor or Manager of the call center or clinic.

Patient Service Specialist

Scripps Green Hospital La Jolla
05.2014 - 06.2018
  • Responsible for interacting with patients, payers and providers to gather information necessary for accurate registration including assigning of appropriate Medical Record Number, scheduling, referral/authorization, point of service payment collection, document collection and arrival/check-in functions
  • Responds to customer billing and payment inquiries as needed
  • Escalating billing inquiries as needed
  • Accurately scheduling patient appointments
  • Successful scheduling includes, but not limited to, exhibiting proficiency in appointment scheduling procedures, accurate documentation and routing of messages, scheduling and confirming appointments according to practice guidelines, entering appropriate insurance, performing Key User duties with minimal errors
  • Was responsible for initiating and validating referrals/authorizations
  • Regularly displays a proactive approach to customer service by listening to the patient, taking ownership of solutions and is able to accurately identify the need to involve leadership in order to resolve concerns.

Education

Bachelors of Science in Healthcare Administration -

Southern New Hampshire University
Manchester, CA
05.2019

Skills

  • EMR systems-Epic, Eclinicworks, Ascend, Central Reach (8 years)
  • Applied Behavior Analysis-Professional 4 yrs, Personal experience 14 yrs (10 years)
  • Microsoft Office-Excel, Word,Powerpoint, Teams, Outlook and Sharepoint (10 years)
  • Administrative experience (10 years)
  • Medical administrative support
  • Typing 45-55 wpm (10 years)
  • HIPAA (7 years)
  • Google Docs (5 years)
  • ICD-10 (7 years)
  • Medical billing (3 years)
  • Medical terminology (10 years)
  • Hospital Administrative Office (5 years)
  • Customer support (10 years)
  • Accounting-Medical Billing (4 years)

Timeline

Referral Coordinator-Data Management

Aces Aba, LLC
10.2021 - 02.2024

Member Service Coordinator-Contracted Position

Curative Inc.
03.2021 - 09.2021

Administrative Assistant (Contracted)

Global Medical Detox
01.2020 - 11.2020

Call Center Representative

Neighborhood Healthcare
06.2018 - 08.2019

Patient Service Specialist

Scripps Green Hospital La Jolla
05.2014 - 06.2018

Bachelors of Science in Healthcare Administration -

Southern New Hampshire University

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Cynthia L. Williams