Katherine Espinal
Houston,TX
Summary
Detail-oriented Financial Clearance Associate with over 2 years of experience in revenue cycle operations, focusing on insurance verification, prior authorizations, and denial resolution. Demonstrates effective workload management, surpasses productivity goals, and collaborates with clinical teams to facilitate timely patient care. Skilled in Epic systems and streamlining financial clearance processes.
Overview
8
8
years of professional experience
Work History
Financial Clearance Associate-RCO
Nyu Langone Hospital
Nyack, New York
03.2024 - Current
- Verified insurance eligibility and benefits for high-cost treatments, including infusions and specialty medications.
- Managed prior authorizations for chemotherapy biologics and specialty drugs to ensure timely processing.
- Reviewed and resolved insurance denials by coordinating appeals for prompt approvals.
- Communicated authorization statuses and requirements to clinical teams and healthcare providers.
- Guided site-of-care optimization between home infusion specialty pharmacy and buy-and-bill options to enhance patient access to therapies.
- Generated self-pay estimates for uninsured patients and those with inactive coverage to facilitate financial planning.
- Tracked medication readiness to ensure timely treatment initiation and minimize patient delays.
Lead Registration
Optum
Rutherford, NJ
12.2021 - 03.2024
- Managed registration process, office functionality, and staff performance to ensure efficient operations
- Coordinated evaluations with insurance companies, successfully overturning denials to secure patient coverage
- Calculate, request, and collect pre-determined patient out-of-pocket responsibilities and process all forms of payment in a timely and accurate manner
- Obtained prior authorizations and conducted MRI insurance clearances
- Appointed as Epic super-user for system malfunctions, customer relations, and patient outreach
- Initiate reviews with adjusters to determine eligibility and validate MVC/WC cases
- Manage and thoroughly review internal/external electronic referrals to ensure proper office payment and reimbursement
- Developed and implemented training programs for new staff, mentoring employees to enhance overall team competency
Patient Care Coordinator
Riverside Medical Group
Rutherford, NJ
12.2020 - 12.2021
- Obtained, collected, and entered patient information in Admissions to streamline data collection, billing, and facility reimbursement
- Coordinated communication with other offices regarding patient lab results to ensure timely information sharing
- Requested and collected patient out-of-pocket responsibilities, processing payments accurately and promptly
- Processed payments in various currencies to ensure transaction accuracy.
- Complete all essential forms to maintain compliance with federal, state, and local requirements
Manager
Creations Smoothies & Frozen Yogurt
Lodi, NJ
05.2018 - 12.2020
- Managed, trained, and developed employees to enhance team capabilities
- Oversaw store operations and analyzed monthly sales to assess profitability
- Delivered exceptional customer service throughout the floor experience, from greeting to order completion
- Implemented and revised inventory system by focusing on storage conditions and demand
- Adapted to pandemic practices, signing on with UberEats and DoorDash
- Tracked incoming shipments to confirm item precision
Education
Some College (No Degree) - Business Administration
Bergen Community College
Paramus, NJHigh School Diploma -
Lodi High School
Lodi, NJ06-2018
Skills
- Patient financial counseling
- Insurance verification
- Authorization management
- Epic proficiency
- Financial analysis
- Attention to detail
- Problem solving
- Collaboration strategies
- Bilingual (English & Spanish)
- Communication skills
Timeline
Financial Clearance Associate-RCO
Nyu Langone Hospital
03.2024 - Current
Lead Registration
Optum
12.2021 - 03.2024
Patient Care Coordinator
Riverside Medical Group
12.2020 - 12.2021
Manager
Creations Smoothies & Frozen Yogurt
05.2018 - 12.2020
Some College (No Degree) - Business Administration
Bergen Community College
High School Diploma -
Lodi High School