HEATHER MYLES
JACKSONVILLE,FL
Summary
Dynamic and results-oriented healthcare professional with 15 years of experience connecting clients with medical providers and managing administrative operations. Proven expertise in team leadership, process improvement, and employee development. Adept at streamlining workflows and enhancing productivity to achieve organizational goals.
Overview
17
17
years of professional experience
Work History
Referral Specialist II/ Mentor
Elevance Health
03.2023 - Current
- 0-1008Collaborated with healthcare providers to ensure accurate and complete referral information, improving patient care coordination
- Streamlined referral processes for increased efficiency, resulting in timely appointments for patients
- Acts as a liaison between hospitals, health plans, physicians, patients, vendors, and other referral sources
- Assigns escalated referrals to staff as appropriate
- Verifies insurance coverage and completes pre-authorization process for radiology and other imaging exams (CT, MRI, MRA, PET, etc.) following established processes and procedures
- Respond to inbound calls initiates exam requests following established processes, meets quality and production standards
- Enters referrals, documents communications and actions in the system
- Manage operations through organizing, scheduling, and monitoring department workload
- Collaborated with clinical and administrative staff to meet patient needs
- Organized and maintained records by updating and obtaining both personal and financial information from patients
- Applied HIPAA privacy and security regulations while handling patient information
- Verified demographics and insurance information to register patients in the computer system
- Answered phone calls and messages for 80-100-physician, medical facility, scheduling appointments, and handling patient inquiries.
Team Lead Patient Access , ER Setting
R1 RCM
05.2021 - 03.2023
- Assigned responsibilities to team members with consideration of the complexity and urgency of tasks, ensuring optimal resource allocation.
- Mentored and evaluated team members, providing constructive feedback and recognizing outstanding performance.
- Guided employees on work-related matters, facilitating problem-solving and administrative clarity.
- Participated in recruitment by interviewing candidates and recommending top prospects for various positions.
- Addressed and resolved employee concerns and mediated complaints, promoting a cohesive work environment.
- Introduced process improvements, increasing accuracy in patient registration and reducing wait times significantly.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Conducted workforce planning, setting short-term priorities to meet operational needs effectively.
Team Lead Patient Access Mammography
Baptist Medical Center
02.2019 - 05.2021
- Planned work schedules for subordinates, adjusting priorities to meet organizational goals and ensuring timely task completion.
- Assigned tasks based on workload difficulty, urgency, and employee expertise to optimize performance and efficiency.
- Evaluated the work performance of team members and provided recommendations for performance recognition or disciplinary actions.
- Offered advice and instructions on administrative and operational procedures to enhance team understanding and compliance.
- Collaborated with leadership in interviewing candidates and recommending appointments, promotions, or reassignments.
- Resolved complaints from staff, escalating unresolved issues or group grievances to senior management as appropriate.
- Implemented minor disciplinary measures, including issuing warnings, while recommending actions for more severe cases when necessary.
- Identified training needs among team members and arranged appropriate development opportunities to enhance skills and productivity.
- Initiated and streamlined workflows to improve departmental efficiency and enhance service quality.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Performed Workforce management duties
Team Lead Patient Access , ER Setting
Physicians Regional Medical Center
02.2015 - 02.2019
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions
- Stayed calm under pressure and successfully dealt with difficult situations
- Provided excellent customer service through active listening skills, understanding patient needs, and offering tailored solutions where applicable
- Facilitated smooth billing processes by verifying insurance eligibility, obtaining authorizations, and accurately entering claim details into the system
- Maintained accurate patient records, contributing to a well-organized database for seamless information access across departments
- Conducted workforce planning, setting short-term priorities to meet operational needs effectively
- Assigned responsibilities to team members with consideration of the complexity and urgency of tasks, ensuring optimal resource allocation
- Mentored and evaluated team members, providing constructive feedback and recognizing outstanding performance
- Guided employees on work-related matters, facilitating problem-solving and administrative clarity
- Participated in recruitment processes by interviewing candidates and recommending top prospects for various positions
- Addressed and resolved employee concerns and mediated complaints, promoting a cohesive work environment
- Introduced process improvements, increasing accuracy in patient registration and reducing wait times significantly
Assistant Facility Administrator
DaVita
10.2007 - 10.2015
- Conducted regular performance evaluations for staff members, providing constructive feedback for professional growth
- Responded on 24-hour, 7-day basis to significant unusual occurrences
- Monitored staff success and conducted physical inspections of facility to comply with policies and procedures
- Assisted in the recruitment process by interviewing candidates, evaluating skills fit, and making hiring recommendations based on organizational needs
- Directed department functions, activities and supervision of personnel
- Increased employee satisfaction by addressing concerns, fostering a positive work environment, and promoting professional development opportunities
- Designed and introduced leadership development, coaching and team management model, resulting in promotion of employees into increased levels of responsibility
- Directed departmental operations, preparing schedules and setting goals for successful project completion.
- Delegated work assignments to team members, taking into account skill levels and project requirements.
- Conducted comprehensive staff performance reviews and proposed both recognition programs and disciplinary measures.
- Provided employees with targeted training and professional development opportunities to meet both individual and organizational goals.
- Recommended and implemented workflow enhancements to boost productivity and ensure the highest quality outcomes.
- Supervised facility maintenance, negotiated vendor contracts, and managed resources to reduce operational costs while ensuring service quality.
Education
M.H.A -
University Of Phoenix
Phoenix, AZ06-2025
MBA -
University of Phoenix
Phoenix, AZ02-2024
Bachelor of Applied Arts And Science - Supervision And Manamement
South Florida State College
Avon Park, FL01-2022
Skills
- Strategic Work Planning and Scheduling
- Staff Supervision and Leadership
- Performance Evaluation and Recognition
- Conflict Resolution and Grievance Handling
- Recruitment and Talent Development
- Training and Development Coordination
- Process Improvement and Quality Enhancement
- HIPAA Regulations Compliance
- Time Management
- Office Coordination
Timeline
Referral Specialist II/ Mentor
Elevance Health
03.2023 - Current
Team Lead Patient Access , ER Setting
R1 RCM
05.2021 - 03.2023
Team Lead Patient Access Mammography
Baptist Medical Center
02.2019 - 05.2021
Team Lead Patient Access , ER Setting
Physicians Regional Medical Center
02.2015 - 02.2019
Assistant Facility Administrator
DaVita
10.2007 - 10.2015
M.H.A -
University Of Phoenix
MBA -
University of Phoenix
Bachelor of Applied Arts And Science - Supervision And Manamement
South Florida State College
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