Laisa Colon
Paterson,NJ
Summary
Dedicated Patient Eligibility Representative and Healthcare Financial Services professional with 10+ years of experience in patient access, insurance verification, eligibility determination, and revenue cycle operations. Skilled in verifying Medicare, Medicaid, and commercial insurance benefits, assisting patients with financial assistance programs, and ensuring compliance with HIPAA regulations. Proven ability to deliver exceptional patient customer service, resolve insurance coverage issues, and support hospital revenue cycle processes. Bilingual professional seeking to contribute expertise in patient eligibility, insurance verification, and financial counseling within a healthcare organization.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Patient Eligibility Representative
ST JOSEPH'S HEALTH
Paterson, NJ
01.2025 - Current
- Perform insurance eligibility verification for scheduled patients prior to medical services to ensure accurate billing and reimbursement.
- Review and validate patient demographics, insurance coverage, copays, deductibles, and benefits in the EMR system.
- Assist uninsured patients with Presumptive Eligibility (PE) Medicaid applications to secure temporary healthcare coverage.
- Coordinate appointments with Charity Care Financial Assistance offices for uninsured or underinsured patients.
- Investigate and resolve insurance coverage discrepancies and eligibility issues to prevent claim denials.
- Maintain strict HIPAA compliance while handling confidential patient and insurance information.
- Provide front desk coverage by assisting with patient registration, appointment check-in, and patient intake processes.
- Maintain working knowledge of Medicare, Medicaid, and commercial insurance plans.
Patient Financial Counselor
CHILTON MEDICAL CENTER AHS
Pompton Plains, NJ
11.2017 - 10.2024
- Conducted patient financial counseling to determine eligibility for Charity Care, Medicaid, and financial assistance programs.
- Processed Presumptive Eligibility (PE) Medicaid applications and assisted patients with healthcare coverage enrollment.
- Performed insurance verification and benefits investigation during hospital admissions, including HMO managed care plans.
- Reviewed patient accounts to determine financial responsibility, payment options, and eligibility for assistance programs.
- Investigated accident-related claims to determine liability for No-Fault and Worker's Compensation insurance coverage.
- Collaborated with management to perform data analysis and reporting to improve departmental operational efficiency.
- Assisted in resolving billing issues, insurance discrepancies, and patient financial concerns.
- Ensured compliance with hospital financial policies and healthcare regulations.
Account Receivable
MAIN WHOLESALE FLORIST
Clifton, NJ
05.2008 - 10.2017
- Managed accounts receivable operations, including payment posting, reconciliation, and account balance monitoring.
- Maintained general ledger entries and tracked customer payment schedules.
- Generated and distributed monthly billing statements and monitored outstanding balances.
- Communicated with customers and sales representatives to resolve past-due accounts and billing discrepancies.
- Performed administrative duties including data entry, phone support, and account documentation.
- Assisted with inventory purchasing and stock management.
Education
Associate of Science - Public Health
Passaic County Community College
Paterson, NJ05-2025
High School Diploma -
Eastside High School
Paterson, NJ06-2003
Skills
- Insurance Eligibility Verification
- Patient Registration & Patient Access
- Presumptive Eligibility (PE) Medicaid Applications
- Charity Care & Financial Assistance Programs
- Patient Financial Counseling
- HIPAA Compliance & Patient Confidentiality
- Medical Office Administration
- Patient Intake & Demographic Verification
- Accounts Receivable & Payment Posting
- Customer Service in Healthcare
- Bilingual Communication (English/Spanish)
Systems: Epic, Meditech, Soarian, Microsoft Word, Excel, Outlook, Revenue Cycle Systems
Certification
PE certified (Presumptive Eligibility) Medicaid
Timeline
Patient Eligibility Representative
ST JOSEPH'S HEALTH
01.2025 - Current
Patient Financial Counselor
CHILTON MEDICAL CENTER AHS
11.2017 - 10.2024
Account Receivable
MAIN WHOLESALE FLORIST
05.2008 - 10.2017
Associate of Science - Public Health
Passaic County Community College
High School Diploma -
Eastside High School