Summary
Highly analytical professional with extensive experience in reviewing claim submissions, obtaining and verifying information; liaising with insurance agents and beneficiaries and processing claim payments. Proven track record of responding to customer questions, providing guidance and communicating to customers through phone calls and emails. Instrumental in coordinating provider credentialing process to increase efficiency and ensure that credentialing deadlines are met. Well-versed at performing administrative functions, scheduling, answering phones, and coordinating general requests in a timely and customer-service oriented manner. Expert at delivering assistance in updating reinsurance systems and information. Hardworking and passionate job seeker with strong organizational skills eager to secure a position which will allow my transferable skills to flourish. As this world transition into health Informatic and data analyst . I have no doubt and ready to do my part in helping the right company achieve goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
19
19
years of professional experience
2
2
Certification
Work History
Patient/Client Services Member Representative
Working Solutions
11.2022 - Current
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Paid attention to detail while completing assignments.
- Demonstrated strong organizational and time management skills while managing multiple projects.
Patient Access Representative /Billing Analyst
JFK Medical Center North Campus
Lake Worth, FL
05.2016 - 08.2024
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
- Enhanced departmental collaboration by regularly liaising with medical, nursing, and administrative staff on pertinent patient matters.
- Streamlined patient registration processes by implementing efficient data collection methods and reducing wait times.
- Improved patient satisfaction scores by actively addressing concerns and providing prompt assistance during the check-in process.
- Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
Claim Processing Specialist/Insurance Verification Specialist
1199SEIU Benefit and Pension Funds
03.2018 - 10.2019
- Reduced claim processing errors through meticulous attention to detail and thorough review of documentation using medical Claims Processing System (QNXT), Teleform Verifier System, Vitech (V3), and 837 workflows with a focus to verify claims
- Facilitated clients by ensuring that all listed items accurately reflect the appropriate information submitted by the provider
- Managed and updated incorrect and incomplete data that appears in red on entry screen and confirmed verification of all medical claims
- Prepared and verified accurate data by using reference files such as enrollment and provider records.
Vanguard Staffing Agcy. Patient Access Rep
New York-Presbyterian Medical Group of Brooklyn
10.2017 - 02.2018
- Communicated and interviewed new patients with a focus to collect required medical and insurance information
- Organized and retrieved patient data as well as scheduled appointments into a multi-practice Athena system to facilitate clients
- Provided excellent customer service by greeting new patients and completing patient demographic information.
Patient Access Representative /Senior Billing Coordinator
Jamaica Hospital Medical Center
Jamaica, NY
05.2009 - 05.2016
- Increased efficiency in managing high call volumes by developing effective phone triage techniques for prioritizing urgent matters.
- Adapted quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.
- Assisted with administrative tasks such as filing, data entry, and report generation to support streamlined office operations.
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
- Developed proficiency in various healthcare software programs for accurate documentation of patient encounters and streamlined workflows within the department.
Senior Patient Access Representative/Senior Billing Analyst
Brookdale Hospital Medical Center
Brooklyn, NY
05.2005 - 05.2009
- Enhanced overall patient experience with empathetic communication and thorough explanations of insurance benefits and coverage.
- Worked with patients to ascertain issues and make referrals to appropriate specialists.
- Resolved patient billing issues in line with established guidelines.
- Optimized organizational systems for payment collections, AP/AR, deposits, and recordkeeping.
- Trained new staff on hospital processes and procedures.
- Helped address client complaints through timely corrective actions and appropriate referrals.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
Education
Bachelor of Science - Business Management
05.2022
School of Business Administration & Information System
Skills
- Claims Processing
- Healthcare Administration
- Health Insurance
- Healthcare Regulatory Compliance
- Database Management
- Customer Service
- Providers Relations
- Problem Solving
- Troubleshooting
Affiliations
- Affiliate Member, National Association Medical Staff Services (NAMSS) –Medical Services Professional (MSP)
- Member, The American Health Information Management Association (AHIMA)
Certification
Medical Billing and Coding Essentials Certificate
Google Data Analytics Professional Certificate
Languages
Spanish
Professional Working
English
Native or Bilingual
Timeline
Patient/Client Services Member Representative - Working Solutions
11.2022 - Current
Claim Processing Specialist/Insurance Verification Specialist - 1199SEIU Benefit and Pension Funds
03.2018 - 10.2019
Vanguard Staffing Agcy. Patient Access Rep - New York-Presbyterian Medical Group of Brooklyn
10.2017 - 02.2018
Patient Access Representative /Billing Analyst - JFK Medical Center North Campus
05.2016 - 08.2024
Patient Access Representative /Senior Billing Coordinator - Jamaica Hospital Medical Center
05.2009 - 05.2016
Senior Patient Access Representative/Senior Billing Analyst - Brookdale Hospital Medical Center
05.2005 - 05.2009
Long Island University - Bachelor of Science, Business Management