Justin Masayon
Rancho Cordova,CA
Summary
Results-oriented Analyst skillful in managing and breaking down large volumes of information. Proactive at heading off issues in operations, workflow and production by uncovering trends affecting business success. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
18
18
years of professional experience
Work History
Senior Provider Identity Management Analyst
CommonSpirit Health
Sacramento, CA
11.2021 - Current
- Collaborated with cross-functional teams to identify opportunities for process improvement and increased efficiency.
- Validated results and performed quality assurance to assess accuracy of data.
- Improved internal knowledge sharing by developing comprehensive documentation outlining standard operating procedures for various tasks.
- Queried databases for information needed for report processing.
- Recommended process improvements to continually identify, analyze and fix constraints and challenges.
- Management of all EIM programs and projects including encouraging and maintaining a positive working environment,Auditing, fostering open communication, setting goals, development, providing coaching and mentoring, coordinating scheduling, aligning training that creates, maintains and grows a capable and professionally skilled staff.
- Monitor staff work efforts to resolve actual and potential duplicate provider and patient medical record conditions, investigate and rectify potential provider overlays, rectify database linkage conditions, and address inactivated records—all within multiple source and destination systems.
EIM Analyst/Provider Task Team
Dignity Health Corporate
01.2017 - 10.2021
- The Enterprise Identity Management Analyst position is responsibility for coordinating the duties necessary to maintain the integrity of the Enterprise Identity Management data for their service Area in accordance with established policies and procedure
- I partner with Dignity Health colleagues to research, analyze and resolve complicated and time-sensitive patient and provider identity and associated information structures across multiple corporate data management systems and among diverse hospital and corporate departments
- I also develop and execute reports, provide support for systems improvement initiatives, and be a contributor to information quality and integration projects.
ACO Coordinator
Dignity Heath Corporate
01.2015 - 01.2017
- Provide administrative support to the manager and director of the SSA Utilization Management department, and other personnel, as applicable to the ACO pilot, at assigned facilities
- Act as a liaison between the hospital case management department and the medical group concurrent review staff to assist their efforts to reduce utilization of avoidable inpatient bed days
- Review medical records to evaluate clinical information to determine those patients that meet specific criteria for appointment making and other programs Contact appropriate outpatient provider to arrange appointments for hospitalized patients Communicate with hospital case manager and/or other hospital based staff regarding patient needs and appointment information Accurate and timely documentation of appointment information in the patient’s medical record Participate in daily rounds Confirm authorizations from medical group Review and document avoidable and denied days Participate in identifying opportunities for improvement of timely discharges to appropriate level of care Assist in obtaining authorizations for services as identified in rounds or by case manager Support program manager in preparation of reports for various meetings Ability to work independently with self-initiative and discipline with minimal supervision Perform office based roles in accordance with department standards Other duties as assigned to meet the program and corporate needs
Experienced Patient Access Support Representative
Mercy Folsom Medical Center
Folsom, CA
01.2012 - 01.2015
- Register patients to receive medical services in ambulatory and emergency services
- Pre-register and register patients for both inpatient/outpatient surgeries and radiology procedures
- Obtain demographic information, validate and verify insurance, collect appropriate co-pays, issue receipts and refer patients to Financial Advocates
- Complete registrations in accurate and timely manner
- Ensure all authorizations and signatures are obtained
- Explain hospital policies and patients’ bill of rights
- Provide information and answer questions about Dignity Health Payment Assistance program
- Verify inpatients insurance eligibility monthly
- Complete third party payer forms
- Contact employer for worker compensation cases to obtain and document carrier information
- Document information in computer systems
- Notify department or nursing station of patient’s arrival
- Provide excellent customer service to patient, family and visitors.
Experienced Patient Access Support Representative
Sutter Medical Foundation
Sacramento, CA
01.2006 - 01.2011
- Greet, identify and register patients at point of service: activate or initiate the medical record and accounts: obtain consent signatures: collect and receive patient’s payments and valuables: obtain authorization for surgical/outpatient procedures and indentifying eligibility
- Assented in patient Advocacy in helping each individual identify out of pocket expenses
- Resolved claims processing issues both in house and worked directly with insurance plans
- Audited individual claims for accuracy and maximum provider reimbursement
- Report audits to identify claim discrepancies with coding and reimbursement claims
- Well versed with Medicare and Medicaid Insurance
- Expert in managing the use of most insurance portals, able to navigate and remediates claims and issues and able to communicate to providers claims issues and how avoid them
- Provided functional guidance and direction to new employees.
Education
Project Management Certification -
Sacramento State College
Skills
- Workflow analysis
- Clinical Quality Management
- Organizational skills
- Insurance Verification Systems: HDX, IDX,MISYS, NAVICARE, Epic, Sun Quest, Passport
- MS4
- Insurance Eligibility Verification
- Performance Improvement
- Internal Control Auditing
- Issue Resolution
- Microsoft Office Suite
- HIPPA trained
- Analytical Thinking
Personal Qualifications
With over 10 years of experience in Health Care Administration, I’m very comfortable working in a fast paced environment where my communication, organizational and follow through skills are showcased. Most importantly, my professional, courteous and customer focus attitude are what I believe make a difference in any work environment.
References
- Kendra Layton, (530) 748-3375, Program Manager Care Coordination, SSJSA Clinical Case Manager
- Carmen Kaufhardt, (916) 983-7430, Director Patient Access, Mercy Hospital of Folsom
- Todd Pate, (916) 631-3617, Mgr Managed Care, Clinical Case Management
Timeline
Senior Provider Identity Management Analyst
CommonSpirit Health
11.2021 - Current
EIM Analyst/Provider Task Team
Dignity Health Corporate
01.2017 - 10.2021
ACO Coordinator
Dignity Heath Corporate
01.2015 - 01.2017
Experienced Patient Access Support Representative
Mercy Folsom Medical Center
01.2012 - 01.2015
Experienced Patient Access Support Representative
Sutter Medical Foundation
01.2006 - 01.2011
Project Management Certification -
Sacramento State College