LISA SEGOVIA
San Antonio
Summary
Motivated and dependable professional with extensive experience in thriving in fast-paced environments, utilizing exceptional skills in patient relations and service satisfaction. Recognized for expertise and sharp insight in negotiating policy, developing and implementing strategic plans, and achieving desired outcomes. Demonstrated proficiency in job execution, with a proven track record of success in compliance, detail responsiveness, process improvement, and leadership. Seeking a full-time position that presents professional challenges, where interpersonal skills, excellent time management, and problem-solving abilities can be applied.
Overview
9
9
years of professional experience
Work History
Patient Access Representative
Florida Blue Cross
01.2024 - Current
- Processed provider authorization requests with speed and precision.
- Coordinated and dispatched fax requests from external providers.
- Coordinated message exchanges utilizing email, fax, and chat platforms.
- Coordinated initial review of pre-determination requests for healthcare services.
- Delivered guidance on the progress of appeals and peer reviews to provider offices.
- Resolved escalated calls related to authorization status.
- Redirected tasks to the designated supervisory team member.
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
- Remained composed under pressure, efficiently managing challenging scenarios.
- Adapted quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.
- Provided excellent customer service through active listening skills, understanding patient needs, and offering tailored solutions where applicable.
Patient Service Representative
Resmed
05.2022 - 01.2024
- Provided exceptional customer service to patients, answering questions and addressing concerns.
- Verified insurance eligibility and coverage for patients.
- Entered patient demographic and insurance data into electronic medical record system.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Answer incoming outgoing calls for patients recording cpap/bipap supplies
- Educate on medical supplies
- Sales
- Verified patient insurance eligibility and entered patient information into system.
- Responded to inquiries by directing calls to appropriate personnel.
- Resolved customer complaints using established follow-up procedures.
- Taught patients and families to use at-home medical equipment.
Front Desk Assistant
SA Eye Center
06.2021 - 08.2021
- Developed and maintained expertise related to Tempus EVV solution
- Tested software, investigate issues and bugs, and Provided excellent patient care with kind, informative, telephone and front desk communication assisted in scheduling, filing, and maintaining patient records, answering office phones, and scanning paperwork into the system
- Gave demographic information to insurance companies and called physicians' offices if clinical information is needed for pre- certification and verified the information obtained
- Obtained complete and accurate demographic and financial information from a variety of sources, including patient interviews, physician offices and in-house departments
- Performed required pre-certification, credit referral or deposit collection
- Entered data in computer and thoroughly documented any incomplete admissions/registrations in manner prescribed
- Performed data entry duties to include demographics and completed various reports in a daily basis such as importing e-mails to be forwarded to the correct personnel
- Demonstrated strong customer relations skills in proactively welcoming patients and vendors when checking them in and out for appointments.
EVV Representative
Aplus Family care
08.2018 - 05.2021
- Developed and maintained expertise related to Tempus EVV solution
- Tested software, investigate issues and bugs, and dialogue with developers to ensure robustness of EVV solution
- Engaged in activities as directed to support full life cycle of Tempus EVV project, performed troubleshooting, user support, enhancements definition
- Ensured that clients are staffed appropriately with caregivers based on physician orders, client’s needs and the skills of the caregivers
- Reviewed timesheets for accuracy, including hours worked, staff and client signatures, detailed documentation of services provided, and tasks codes to match EVV clock in/out
- Participated in time and attendance, and sick leave verification process for caregiver payroll
- Ins/outs; and staffing needs to clinical team and HR, respectively
- Reconciled clock ins/outs and timesheets, adjusting schedules to reflect actual hours rendered, monitoring, and resolving daily alerts or discrepancies.
Certified Nursing Assistant
Four Seasons
10.2017 - 03.2018
- Delivered quality-nursing care for Rehab, Hospice, and Long-term care patients
- Checked patients' pulse, temperature, and respiration, and assist with blood sugar monitoring
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
- Checked patient vitals such as temperature, blood pressure, and blood sugar levels.
- Promoted good oral and personal hygiene by aiding patients with shaving, bathing, and teeth brushing.
- Cared for clients with diagnoses such as respiratory failure, diabetes, Parkinson's disease and muscular dystrophy.
- Helped patients with self-feeding and assisted feeding, based on individual needs.
- Assisted nursing staff with completing daily rounds, documenting vital signs and answering calls.
- Transported patients between rooms and appointments or testing locations.
- Helped patients complete range of motion exercises to prevent loss of function during care.
Coordinator/Payroll Assistant
Girling Home healthcare
01.2016 - 03.2017
- Learning and mastering the EVV software system
- Monitored employee schedules hourly to ensure PCAs have arrived for their shifts
- Triage time and attendance issues and escalate as applicable to Scheduling Coordinators and or Supervisors
- Reviewed and verified employee time and attendance records are correct
- Reacted immediately to variance in shifts and schedules and track all pending attendance and payroll issues
- Communicated with PCAs, Consumers, Scheduling Coordinators, and Supervisors to resolve any payroll discrepancies related to employee timecard records
- Maintaining documentation in EVV software (notes, communication, etc.) Completed daily time and attendance review, tracked and followed up within the pre-established timetables for each task
- Complete final payroll review for current week payroll and coordinate with Accounting Unit for processing of payroll.
- Processed new hire paperwork and documents.
- Verified timekeeping records and handled any discrepancies with employees.
- Responded to employee questions and requests for information in timely and knowledgeable fashion.
- Maintained employee privacy and protected payroll operations by keeping all information confidential.
- Responded to employee inquiries to clarify payroll issues regarding wages, deductions and taxes.
- Audited timesheets and payroll records for accuracy.
Education
Academy for Massage San Antonio
2013
Certified Nursing Assistant -
Merit College Preparatory Academy
12.2012
Skills
- Health Assessments Insurance knowledge Treatment Planning Disease Prevention Patient Education Preventive Care
- Documentation & Control Training & Development Performance Improvement Data Entry Critical Thinker
- Reports/Documentation Result Execution Customer Relations Communication Skills Attention to Detail
- Problem Solving Technical Support Conflict Resolution Time Management Process Improvement
- Microsoft Office Documentation & Control Strategic Planning Team Management Leadership
- Insurance Verification
- Collection Management
- Clinical Data Entry
- Patient Account Reviews
- Multi-Line Telephone Systems
- HIPAA Compliance
- Patient Engagement
- Outbound Calling
- Patient Interviewing Skills
Timeline
Patient Access Representative
Florida Blue Cross
01.2024 - Current
Patient Service Representative
Resmed
05.2022 - 01.2024
Front Desk Assistant
SA Eye Center
06.2021 - 08.2021
EVV Representative
Aplus Family care
08.2018 - 05.2021
Certified Nursing Assistant
Four Seasons
10.2017 - 03.2018
Coordinator/Payroll Assistant
Girling Home healthcare
01.2016 - 03.2017
Academy for Massage San Antonio
Certified Nursing Assistant -
Merit College Preparatory Academy
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