ERIKA GOVEA
Stowe,PA
Summary
Detail-oriented healthcare professional with over 9 years in clinical and operational roles, including 3.5 years in Medical Assistant leadership. Expertise in patient intake, eligibility review, CPT-code validation, and referral coordination, ensuring compliance with HIPAA regulations. Proven ability to streamline processes and enhance communication among patients, providers, and stakeholders.
Overview
2
2
Languages
10
10
years of professional experience
Work History
Care Coordinator
ProgenyHealth
2022.12 - 2026.04
- Conducted high-volume client and family outreach and screening to assess needs, gather relevant information, and establish appropriate care pathways for improved patient support.
- Reviewed medical documentation in CRM and EHR systems to verify patient information and maintain accurate records, enabling effective tracking of case trends.
- Educated families regarding program criteria, clinical resources, and financial requirements while maintaining strict HIPAA compliance.
- Educated families on program criteria, clinical resources, and financial requirements while ensuring strict HIPAA compliance to facilitate informed decision-making.
- Managed phone- and virtual-based workflows independently in a fully remote environment while maintaining consistent documentation and follow-through.
- Worked remotely to support various tasks and responsibilities
Case Management Associate – Team Lead
Opyn Marketplace (formerly Transparent Marketplace)
2021.11 - 2022.12
- Coordinated workers’ compensation cases, facilitating communication among injured workers, healthcare providers, insurance representatives, and workers’ compensation adjusters to ensure streamlined case management.
- Processed workers’ compensation prescriptions/services and reviewed CPT codes to ensure compliance with applicable requirements, advancing cases efficiently through the system.
- Coordinated appointments and maintained follow-up across multiple stakeholders to keep cases progressing and prevent avoidable delays.
- Processed workers’ compensation prescriptions/services and reviewed CPT codes to confirm services aligned with applicable requirements before moving cases forward.
- Acted as primary point of contact for escalated cases, resolving documentation and coordination issues to enhance collaboration among providers, clients, and adjusters.
- Designed and implemented initial case documentation and client intake workflows in a high-growth startup environment.
- Supported team operations and established repeatable processes.
Medical Assistant Team Leader
Delaware Valley Community Health (DVCH)
2016.09 - 2021.11
- Supervised reception and intake operations supporting 200+ patients while maintaining accurate records and efficient patient flow.
- Mentored team members and supported consistent intake, scheduling, and documentation practices.
- Interviewed patients and families to gather medical histories, verify insurance and financial information, and complete program registration, ensuring accurate and comprehensive patient records.
- Managed referral tracking and coordinated scheduling, identifying documentation gaps and facilitating follow-up to enhance patient care continuity.
- Interviewed patients and families to gather medical histories, verify insurance and financial information, and complete program registration.
- Handled sensitive protected health information in accordance with HIPAA requirements and reinforced safety and compliance procedures.
- Mentored team members to ensure consistent intake, scheduling, and documentation practices, fostering a collaborative and efficient work environment.
Education
Medical Assistance - Specialized Studies – Medical Assistance
Star Career Academy
PA06.2016
Skills
- Intake support
- Referral Management
- Eligibility Verification
- CPT code verification
- Workers’ Compensation Coordination
- Patient screening
- Care Coordination
- Appointment Coordination
- Clinical Workflow Support
- Data Accuracy
- Records Management
- Compliance & Operations: HIPAA / PHI Compliance
- High-volume outreach
- Remote teamwork
- EHR / EMR/ CMR
- Cross-Department Coordination
- Escalation & Issue Resolution
- Provider liaison
Languages
Spanish
English
Timeline
Care Coordinator
ProgenyHealth
2022.12 - 2026.04
Case Management Associate – Team Lead
Opyn Marketplace (formerly Transparent Marketplace)
2021.11 - 2022.12
Medical Assistant Team Leader
Delaware Valley Community Health (DVCH)
2016.09 - 2021.11
Medical Assistance - Specialized Studies – Medical Assistance
Star Career Academy