LILY ALVARADO

• Responsible for providing feedback on daily registration processes and staffing issues to the Patient Access Supervisor
• Provided assistance to staff level employees as necessary to insure compliance with department policies and procedures
• Assisted supervisor with staffing, report reconciliation, QA process, and other duties as assigned
• Reviewed reports, audited and other information to evaluate the training programs effectiveness and improve efficiency
• Interviewed and observed operating personnel to collect information on and produce charts showing workflow patterns, lines of authority, or organizational layout
• Collected and entered patient demographic and insurance data into computer database to establish patient's medical record and determined eligibility for benefits for specific services rendered
• Identified insurance payment sources and listed payers in proper sequence to establish chain of payment
• Trained new staff on hospital processes and procedures
• Greeted and assisted patients with check-in procedures.

• Career break for maternity leave

• Collecting accurate and thorough patient demographic data
• Obtaining insurance information, verify eligibility and benefit, and then contact patients with their benefits
• Subject matter expert in completing the Prior Authorization process with insurance companies and practitioner offices
• Answered phone calls and provided new patients with required paperwork to initiate services.

Front Desk/ Prior Authorization Coordinator/ Medical Biller 2012-2016

• Greeted incoming patients professionally and provided friendly, knowledgeable assistance
• Check in patients for appointments
• Kept reception area clean and neat to give visitors positive first impression
• Ensure patient data is accurate in all information systems
• Confirmed appointments, communicated with patients and updated patient's records
• Obtain and verify appropriate insurance information and patient demographics including copies of insurance and identification card
• Collect and appropriately document all payments in petty cash
• Processed insurance eligibility and directly coordinated any prior authorization
• Assisted in any problem resolution such as getting urgent referrals approved
• Prepared documentation protocols for medical insurance, tracking authorization submissions processing any clinical notes, coded changes and referral modifications in an organized manner
• Verified eligibility for Medi-Cal and PPO's patients
• Billed daily 60+ sick visits, CHDP services, FPact services, and Medicare patients.

Clinic Team Leader 2016-2019

• Interviewed, hired, and trained new staff in accordance with HR guidelines
• Monitored and approved time off for staff
• Conducted employee evaluations, performed disciplinary actions and terminations, planned new hire training and forward complete documentation to VP of Operations and HR in a timely manner
• Ensured staffing was appropriate for day to day operations
• Handled patient grievances in a timely manner
• Reviewed and resolved complaints received from staff, physicians, and patients

• Assisted patients with checking in and out, scheduled appointments and insurance verifications
• For non-insured patients, discussed established self-pay rates and collected payment
• Answered telephones, greeted patients, entered demographics and updated patient information into database
• Reviewed physician notes and charts for billing
• Prepared the appropriate claims documents required by each insurance
• Communicated with insurance providers to resolve denied claims and resubmitted
• Collected payments and applied to patient accounts
• Delivered timely and accurate charge submissions
• Reviewed patient diagnosis codes to verify accuracy and completeness.