Summary
Overview
Work History
Education
Skills
Certification
Languages
Timeline
BusinessAnalyst

Jennifer Romero

Homestead,FL

Summary

Healthcare administrator bringing 10 years of successful history identifying process breakdowns in office & hospital billing, collections and cash posting processes. Dedicated to implementing innovative solutions to address issues. Expertise in evaluating and analyzing operational, clinical and financial performance. Analytical and responsive professional committed to decreasing unnecessary expenses and improving efficiency. Versatile Revenue Cycle Management Analyst with advanced knowledge of financial, business development and operational areas. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

10
10
years of professional experience
1
1
Certification

Work History

Healthcare Consultant

Ellie Mental Health
02.2024 - Current
  • Verified the accuracy of health insurances being inputted in EMR system Valant such as Policy/Group number, Spelling of name, Date of birth, etc. of an average of 250 a week.
  • Reviewing EOB for accuracy of payment over 100 weekly.
  • Assisting office with Insurance denials & appeals
  • Improved patient care quality by conducting comprehensive assessments, identifying gaps in service provision, and recommending evidence-based solutions.
  • Education on reviewing and understanding eligibilities as well as prior authorization requirements.
  • Developed customized healthcare strategies for clients, resulting in enhanced operational efficiency and patient satisfaction.
  • Analyzed complex data sets to identify trends and areas of improvement, leading to the development of targeted action plans.
  • Evaluated the efficacy of existing healthcare programs using performance metrics, enabling informed decisions about program continuation or modification.
  • Implemented process improvements that increased efficiency and reduced waste within client organizations'' operations.
  • Provided ongoing support to clients during periods of transition or organizational restructuring, minimizing disruptions to daily operations while maximizing overall effectiveness.

Revenue Cycle Specialist

GARNET & CARBONELL D.P.M LLC.
03.2022 - Current
  • Identified and resolved payment issues between patients and providers.
  • Increased revenue by identifying and resolving billing errors in a timely manner.
  • Streamlined the revenue cycle process for improved efficiency and faster payment collection.
  • Enhanced customer satisfaction by promptly addressing and resolving billing disputes.
  • Ensured accurate billing with thorough audits of patient accounts and insurance claims.
  • Reduced outstanding account balances by implementing effective collection strategies.
  • Collaborated with cross-functional teams to improve overall financial performance of the organization.
  • Analyzed financial reports to identify trends and areas for improvement in revenue cycle operations.
  • Trained new team members on revenue cycle best practices, contributing to a more knowledgeable workforce.
  • Contacted responsible parties for past due debts.
  • Reached out to insurance companies to verify coverage.
  • Balanced and reconciled accounts.
  • Generated receivables reports and offered improvement recommendations.
  • Developed financial projections and forecasts to guide investment decisions.
  • Generated comprehensive reports on portfolio performance and risk assessment.
  • Created and maintained precise and accurate models, charts and reports.
  • Created financial strategies to optimize portfolio performance and reduce risk.
  • Tracked prices, yields and other trends to correctly interpret impacts on cash flow

Cancer Center Quality Assurance

Larkin Community Hospital
09.2019 - 03.2022
  • Streamlined patient registration process by implementing efficient workflows and reducing wait times.
  • Enhanced patient satisfaction with improved communication strategies and timely resolution of issues.
  • Improved software quality by designing and executing comprehensive test plans and test cases.
  • Developed a comprehensive training program for new employees, ensuring thorough understanding of job responsibilities and hospital policies.
  • Optimized staff scheduling to maintain adequate coverage during peak hours, minimizing patient wait times and improving service quality.
  • Reduced employee turnover rate by fostering a positive work environment and providing ongoing support for professional development opportunities.
  • Managed day-to-day operations of the Patient Access department, ensuring all tasks were completed accurately and in a timely manner.
  • Oversaw staff recruitment efforts, selecting top talent to join the team and contribute to the department''s success.
  • Conducted regular performance reviews for staff members, providing constructive feedback and setting goals for future growth and development.
  • Maintained compliance with all relevant regulations including HIPAA guidelines on patient privacy protection while handling sensitive information during registration processes.
  • Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
  • Providing excellent customer service by promptly answering patient inquiries.
  • Trained new staff on hospital processes and procedures.
  • Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
  • Identified defects in software products through thorough testing and verification processes.
  • Enhanced product reliability with rigorous regression, performance, and stress testing.
  • Collaborated with cross-functional teams to ensure timely delivery of high-quality products.

Corporate Contract & Credentialing Manager

LARKIN COMMUNITY HOSPITAL
01.2019 - 03.2022
  • Verified submitted documents for completeness and compliance with company policies, addressing discrepancies and collaborating to troubleshoot where necessary
  • Developed and followed processes to manage contracts and remain in compliance with company commitments and regulatory obligations.
  • Accomplished multiple tasks within established timeframes.
  • Managed and motivated employees to be productive and engaged in work.
  • Maintained professional, organized, and safe environment for employees and patrons.
  • Resolved staff member conflicts, actively listening to concerns and finding appropriate middle ground.
  • Tracked contracts for management and issued regular tracking reports covering current status and upcoming milestones.
  • Mitigated business risks by analyzing contracts' potential impacts and avoiding unfavorable terms for 5 Facility contracts at a time. And several others for individual provider contracts.
  • Compiled required documentation to keep contracts compliant with Medicare & Medicaid requirements.
  • Onboarded and trained new staff to keep team efficient and prepare team members to effectively handle demands of simultaneous and large-scale contracts.
  • Interpreted contact terms and coordinated solutions to resolve disputes between clients and service providers.
  • Worked closely with account team to identify areas to improve cash flow and leverage tools to improve cash flow from contracts.
  • Worked with departments to find new and better items to fulfill diverse needs.
  • Assessed product quality by monitoring quality assurance metrics, reports and dashboards.
  • Performed root cause analysis to identify and resolve quality issues and defects.
  • Conducted process and system audits to identify areas of improvement and enforce compliance with industry standards.
  • Developed and implemented comprehensive quality assurance plans to monitor product quality and adherence to regulatory standards.
  • Investigated customer complaints and performed corrective actions to resolve quality issues.
  • Collaborated with cross-functional teams to develop and implement process and system improvements.
  • Established and tracked quality department goals and objectives.

LEAD INSURANCE VERIFER

LARKIN COMMUNITY HOSPITAL
07.2016 - 01.2019
  • Established contact with ordering physician's office to resolve any issues or to collect missing vital information.
  • Verified all patient demographic information when registering for services.
  • Reviewed 300 patient cases and insurance coverage information per week.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff.
  • Complied with HIPAA guidelines and regulations for confidential patient data.
  • Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
  • Assisted patients with understanding personalized insurance coverage and benefits.
  • Trained new staff on current, correct insurance verification procedures.
  • Established and maintained relationships with insurance providers for productive communications.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Posted payments to accounts and maintained records.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Generated reports to track insurance verifications and claim progress.
  • Communicated verification and authorization status updates with Case Management department to facilitate decision-making for patient admissions and insurance coverage.
  • Conducted patient intake interviews, recording and documenting relevant information.

MEDICAL ASSISTANT & MEDICAL RECORDS CORRDINATOR

DR. RUBEN AYALA MD PA.
09.2014 - 07.2016
  • Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
  • Sanitized, restocked, and organized exam rooms and medical equipment.
  • Obtained client medical history, medication information, symptoms, and allergies.
  • Called and faxed pharmacies to submit prescriptions and refills.
  • Kept medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted.
  • Assisted with routine checks and diagnostic testing by collecting and processing specimens.
  • Verified patient insurance coverage and collected required co-payments.
  • Completed EKGs and other tests based on patient presentation in office.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff.
  • Obtained and documented patient medical history, vital signs and current complaints at intake.
  • Collected pertinent data and calculations to aid physician in interpreting results.
  • Conducted monthly and quarterly inventory of supplies using facility cost reporting records.
  • Oriented and trained new staff on proper procedures and policies.
  • Uploaded records to patient's individual vault.
  • Processed medical records requests from outside providers according to facility, state, and federal law.
  • Kept accurate log of requests for medical information and records.
  • Obtained necessary signatures on information release forms to obtain medical and treatment records from other service providers.
  • Maintained accuracy, completeness, and security for medical records and health information.
  • Identified new methods to optimize medical records management.
  • Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.

Education

Healthcare Administration -

MEDVANCE MEDICAL INSTITUTE
Miami, FL

High School Diploma -

SOUTHWEST MIAMI SENIOR HIGH
Miami, FL

Skills

  • Insurance Collaboration
  • Claims Review
  • Analytical Research
  • Variance Analysis
  • Impact Assessment
  • Risk Mitigation
  • Revenue Cycle Management
  • Compliance
  • Quality Improvement
  • Client Engagement
  • Healthcare Operations
  • Healthcare Management
  • Healthcare Education
  • Healthcare administration
  • Healthcare finance
  • Healthcare Risk Management
  • Healthcare Networking

Certification

White Belt - Six Sigma Lean

Languages

Spanish
Native or Bilingual
English
Native or Bilingual

Timeline

Healthcare Consultant

Ellie Mental Health
02.2024 - Current

Revenue Cycle Specialist

GARNET & CARBONELL D.P.M LLC.
03.2022 - Current

Cancer Center Quality Assurance

Larkin Community Hospital
09.2019 - 03.2022

Corporate Contract & Credentialing Manager

LARKIN COMMUNITY HOSPITAL
01.2019 - 03.2022

LEAD INSURANCE VERIFER

LARKIN COMMUNITY HOSPITAL
07.2016 - 01.2019

MEDICAL ASSISTANT & MEDICAL RECORDS CORRDINATOR

DR. RUBEN AYALA MD PA.
09.2014 - 07.2016

Healthcare Administration -

MEDVANCE MEDICAL INSTITUTE

High School Diploma -

SOUTHWEST MIAMI SENIOR HIGH

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Jennifer Romero