Hilcia Espinal
Summary
Dynamic benefits analyst with extensive experience in customer service at Cape Cod Hospital. Proven track record in documentation and benefits interpretation, resulting in enhanced patient understanding and compliance. Strong analytical and problem-solving skills have significantly improved patient communication and satisfaction. Committed to furthering expertise in healthcare benefits management to optimize patient outcomes.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Insurance Benefit Analyst
Cape Cod Hospital
11.2021 - Current
- Provided excellent customer service to patients, addressing concerns and resolving issues related to their benefit plans.
- Explained benefits to plan participants in easy to understand terms in order to provide estimate.
- Resolved issues and inquiries from plan participants regarding health benefits and deductions through telephone and via email.
- Prepared detailed estimate using patient benefit information
- Ensured compliance with all applicable laws and regulations by staying current with the "No Surprise Act".
- Proven ability to learn quickly and adapt to new situations.
- Demonstrated a high level of initiative and creativity while tackling difficult tasks.
- Strengthened communication skills through regular interactions with others.
- Excellent communication skills, both verbal and written.
- Passionate about learning and committed to continual improvement.
- Demonstrated strong organizational and time management skills while managing multiple projects.
- Coordinated benefits-related communications with employees, including updates on benefits, plan changes, and other pertinent information.
- Prepared detailed estimates on benefits, informing patients of their responsibilities.
- Researched and analyzed different insurance benefits and also reach out to insurance company to verify benefits.
- Provide estimates to patient's with and without health insurance.
- Call patient's daily from the work queue and provide verbal and written estimates.
- Provide estimates for patients via incoming calls, voice messages, emails, and work queue.
- Record and document patient estimate via excel spreadsheet, upload estimate via media manager and send copy of estimate to patient's via mychart.
Medical Assistant
Lynn Community Health Center
01.2015 - 08.2021
- Provide Spanish interpreting for providers and nurses during patient visits and teachings
- Measure vital signs, perform eye exams and hearing tests
- Performing EKG test, nebulizer treatment, PFT/Spirometry and pulse Oximetry
- Performs Rapid strep test, Hemoglobin A1C and QC/Quality control testing procedure
- Update patient health maintenance
- Scheduling Covid 19 Vaccination
- Schedule Covid 19 testing
- Outreach for Covid 19 patients, calling about symptoms and if symptoms have improved or worsen
- Screen patients for Covid 19 symptoms either in person or via phone call.
Community Health Worker
Lynn Community Health Center
11.2007 - 01.2015
- Referred clients to partner agencies for additional services
- Collaborated with team members to identify client barriers
- Educate residents and families about available services and resources
- Advocates and strives to protect the health, safety and rights of patients
- Maintained organized documentation and patient files
- Facilitated health by cultivating caring relationships with clients
- Strong organizational and time management skills
- Good work attitude
- Ability to work both independently and part of a team
- Experience providing health education
- Strong interpersonal communication skills
- Strong advocate for patient rights
- Experience in testing, teaching and treating Latent TB infection
- Experience working with Hanna Haptu implementing care and treatment of patient with LTBI since the start of TB program of LCHC
- Good understanding of the cultural beliefs of patients born outside of the USA
- Provide support to patents & families during appointments and after appointments as necessary
Education
Certification - Medical Interpreter Program
North Shore Community College
Lynn, MA01.2012
Diploma - HIPAA/OSHA Knowledge
Everest Institute
Chelsea, MASkills
- DOCUMENTATION
- BILLING
- ICD-9
- Clinical EMR Proficiency
- Customer service
- CPT coding
- ICD-10
- Medical billing
- Benefits Analysis
- Adaptability
- Proficient in Task Management
- Documentation Skills
- Attention to Detail
- Written and oral communication
- Analytical Problem-Solving
- Benefits interpretation
Certification
- National Certified Medical Assistant, 09/01/21, 09/01/23
- CPR Certification
Personal Information
Title: Certified Medical Assistant
Timeline
Insurance Benefit Analyst
Cape Cod Hospital
11.2021 - Current
Medical Assistant
Lynn Community Health Center
01.2015 - 08.2021
Community Health Worker
Lynn Community Health Center
11.2007 - 01.2015
- National Certified Medical Assistant, 09/01/21, 09/01/23
- CPR Certification
Certification - Medical Interpreter Program
North Shore Community College
Diploma - HIPAA/OSHA Knowledge
Everest Institute
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