Dedicated professional with strong telephone etiquette and cash management skills. Experienced in enhancing customer satisfaction through effective problem-solving and attention to detail.
Overview
8
8
years of professional experience
Work History
Patient Access Services Clerk
Maui Health System
11.2025 - Current
Processed patient information and documentation with attention to detail.
Assisted in scheduling appointments and managing office logistics efficiently.
Maintained accurate filing systems for patient records and administrative documents.
Collaborated with healthcare professionals to support patient care initiatives.
Establishes patient financial class type at point of registration; obtains necessary insurance information; ensures appropriate forms are completed/initiated/routed; photocopies insurance cards, etc
Registers patients in KP Health Connect; enters accurate demographic, financial class, and insurance information; makes revisions to systems database immediately as errors are recognized to ensure database accuracy
Processes direct, urgent admissions and coordinates with Nursing Supervisor. Contacts physician for/or receives admitting orders and diagnosis for admission of patient. Creates account for impending admission.
Member Care Services Associate - Quest Integration
Pyramid Consulting Inc
03.2024 - 11.2025
Provided case management services to Kaiser Permanente Quest Integration(QI) members and their families ti help navigate personal, social, financial, and medical needs. Worked with QI RN Manager to assign QI members (adults, seniors, and children) with special health care needs to appropriate care manager(CM)/care coordinator(CC).
Worked with RN Manager to develop QI processes for successful care management integration.
Developed and implemented tracking systems for QI processes including, but not limited to, QI Face to Face Health Functional Assessments (HFA) and Personal Assessments of Total Health (PATH).
Demonstrated knowledge of and skill in adaptability, customer service, interpersonal relations, oral communication, problem solving, teamwork, and written communication.
Demonstrated knowledge of and skill in word processing, spreadsheet, and database PC applications.
Claims Director
HWMG
04.2018 - 03.2024
Led claims processing initiatives to enhance operational efficiency and accuracy.
Developed strategic policies that improved claims management and reduced processing times.
Mentored team members on best practices for claims resolution and customer service excellence.
Analyzed claims data to identify trends, recommending adjustments to reduce loss ratios.
Created reports and claim activities, trends, and costs for senior management review.
Presented findings at executive meetings regarding key initiatives within the department.
Interpreted policy terms and conditions to determine coverage eligibility for submitted claims.
Decided appropriate courses of action and presented solutions for claim resolution.
Identified training requirements to further develop claims teams performances.
Customer Service Director
HWMG
11.2017 - 04.2018
Led customer service team to enhance client satisfaction and retention strategies.
Developed training programs to improve service quality and team performance.
Analyzed customer feedback data to identify improvement areas and drive operational changes.
Implemented new CRM tools to streamline communication and increase response efficiency.
Resolved customer complaints or answered questions regarding policies and procedures.
Worked with management team to streamline customer service processes.
Evaluated and developed performance of customer service employees to maximize productivity.
Monitored call center metrics such as average handle time, first call resolution rate, and abandoned calls rate to ensure quality standards were being met.
Conducted regular meetings with staff to discuss current trends in the industry as well as any challenges they may be facing.
Measured and tracked KPIs to enhance customer experience and improve customer retention.
Education
Associate of Science - General Studies
University of Hawaii At Kapiolani Community College Campus
Honolulu, HI
06-1996
Skills
Telephone etiquette
Customer satisfaction
Cash handling
Cash management
Team leadership
Time management
Friendly, positive attitude
Teamwork and collaboration
Problem-solving
Organization skills
Data entry
In-depth insurance knowledge
Verbal and written communication
Insurance verification
Patient registration
HIPAA compliance
Languages
English
Ilocano
Timeline
Patient Access Services Clerk
Maui Health System
11.2025 - Current
Member Care Services Associate - Quest Integration
Pyramid Consulting Inc
03.2024 - 11.2025
Claims Director
HWMG
04.2018 - 03.2024
Customer Service Director
HWMG
11.2017 - 04.2018
Associate of Science - General Studies
University of Hawaii At Kapiolani Community College Campus
Patient Access Representative at Saint Thomas Rutherford West Hospital- R1 RCMPatient Access Representative at Saint Thomas Rutherford West Hospital- R1 RCM