DEBORA M. QUINTEROS

• Responsible for day to day operations of staff and client needs
• Manage and orient staff; assigns work, develops work schedules, instructs in proper procedures; assists with development and revision of department processes/procedures.
• Monitor staff performance, provides employee recognition and feedback
• Document issues and concerns to their direct supervisor
• Work collaboratively with the Regional VP to establish staff goals.
• Monitor overall project performance and provides monthly analysis of certification performance; reports findings and implements solutions when negative trends are noted
• Monitor billing procedures and documentation and provides updates with regulatory compliance; conducts periodic audits; and maintains files.
• Develop relationships with clients and county agencies
• Serve as the Point of Contact for Elevate PFS’s client hospitals and Address client issues immediately as they arise
• Ensure all communication from patients and providers have timely follow-up and resolution of complaints and concerns
• Provide adequate training needs to the staff related to policies/procedures or government regulations
• Represent Elevate PFS at client department meetings
• Develop and implement effective communication channels to provide information to all staff members
• Work collaboratively with other facets of the operations which includes Disability, AR Services, Early Out, IT and HR.
• Other duties as assigned.

• Manage follow up and resolution of complex cases or those requiring the appeals process
• Act as a mentor for other Patient Advocates and assisting in the training process for new staff
• Being a resource for Patient Advocates questions related to process, programs, payers, etc.
• Escalate any problems or concerns to Supervisor, Regional Director and/or Director of Operations
• Screen uninsured hospital patients in an effort to find government programs to cover medical expenses
• Complete the appropriate applications and following through until approved
• Detailed, accurate and timely documentation in applicable Company programs and the hospital systems on all cases worked
• Provide exceptional customer service skills at all times
• Participate in ongoing trainings in order to apply the content learned in dealings with patients and cases
• Maintain work queue of patient accounts, as assigned
• Collaborate with hospital staff, case managers, social workers, financial counselors
• Attend assigned meetings with the client as needed
• Assist in preparation of any reports that will be distributed to the client
• Provide mentorship to other advocates as assigned by Project Manager 
• Other duties as assigned.

• Screen patients and/or patient's representative to determine potential eligibility for third party resources
• Explain to patients and other entities the eligibility requirements, application process and verification requirements for applicable programs
• Facilitate the application process when appropriate for the patient by assisting the patient in completing the application, ROI and ATR forms, scheduling appointment interviews and obtaining required verifications
• Document pertinent patient information in the appropriate systems dictated by the health care facility and DECO business practices
• Document account activity as required by DECO policies and procedures in order to support account dispositions
• Determine potential eligibility for health care coverage in accordance with state/federal/local policies and procedures
• Monitor patient accounts to ensure appropriate processing timeframes are met
• Maintain confidentiality regarding patient's health records
• Submit accurate patient billing information which is contingent upon accounts being billed appropriately
• Responsible for accurately documenting time record for all time worked and maintaining the work schedule as assigned
• Certified marketplace navigator for South Carolina
• Certified marketplace navigator for DC

Screen uninsured hospital patients in an effort to determine if patient is a viable candidate for federal, state, and/or county medical or disability assistance.
Complete the appropriate applications and following through until approved
Detailed, accurate and timely documentation in applicable Company programs and the hospital systems on all cases worked
Provide exceptional customer service skills at all times
Participate in ongoing trainings in order to apply the content learned in dealings with patients and cases
Maintain assigned work queue of patient accounts
Collaborate with hospital staff, case managers, social workers, financial counselors
Answer incoming telephone calls, make out-bound calls, and track all paperwork necessary to submit enrollment and renewal for prospective Medicaid patients.

Maintain structured and timely contact with the applicant and responsible government agency, by phone whenever possible or as structured via the daily work queue.
Assist the applicant with gathering any additional reports or records, meeting appointment dates and times and arrange transportation if warranted
Request home visits as needed to acquire documentation
As per established protocols, inform the client in a timely manner of all approvals and denials of coverage
Participate in additional training requirements in an effort to stay abreast of the ever-changing rules and regulations associated with the various governmental programs
Other duties as assigned.

Screen uninsured hospital patients in an effort to determine if patient is a viable candidate for federal, state, and/or county medical or disability assistance.
Complete the appropriate applications and following through until approved
Detailed, accurate and timely documentation in applicable Company programs and the hospital systems on all cases worked
Provide exceptional customer service skills at all times
Participate in ongoing trainings in order to apply the content learned in dealings with patients and cases
Maintain assigned work queue of patient accounts
Collaborate with hospital staff, case managers, social workers, financial counselors
Answer incoming telephone calls, make out-bound calls, and track all paperwork necessary to submit enrollment and renewal for prospective Medicaid patients.

Maintain structured and timely contact with the applicant and responsible government agency, by phone whenever possible or as structured via the daily work queue.
Assist the applicant with gathering any additional reports or records, meeting appointment dates and times and arrange transportation if warranted
Request home visits as needed to acquire documentation
As per established protocols, inform the client in a timely manner of all approvals and denials of coverage
Participate in additional training requirements in an effort to stay abreast of the ever-changing rules and regulations associated with the various governmental programs
Other duties as assigned.