Open To Work
LISA SEGOVIA
San Antonio
Work Preference
Summary
Detail-oriented Healthcare Customer Service and Patient Access Specialist with 7 years of experience in call centers and clinical environments. Expertise in scheduling, insurance verification, billing, and revenue cycle management. Managed high call volumes while ensuring HIPAA compliance and collaborating with clinical teams to enhance workflows and support financial processes.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Patient Access Specialist
Hummingbird Healthcare
01.2025 - Current
- Serve as primary contact in a high-volume call center, managing scheduling and referrals using Epic EMR.
- Coordinate patient appointments and update demographic/insurance data while ensuring HIPAA compliance.
- Assist patients with MyChart portal access, prescription requests, and test results while explaining benefits and copays.
- Escalate complex clinical inquiries to providers and support care teams with accurate documentation.
- Collaborate with revenue cycle teams to refine workflow efficiency and improve patient satisfaction.
- Consistently met departmental KPI metrics for scheduling accuracy, patient satisfaction, and call handling performance.
- Utilized Genesis phone system to manage high-volume inbound and outbound patient communications efficiently.
Prior Authorization Specialist
Florida Blue
01.2024 - 05.2025
- Processed 100+ weekly prior authorizations for medical, pharmacy, and DME services via Jiva, applying CPT/HCPCS coding.
- Ensured coverage compliance by reviewing clinical documentation and maintained 98% accuracy in eligibility verification.
- Improved authorization turnaround by 30% through proactive provider and payer coordination.
- Utilized EOB and COB analysis to support denial prevention and benefits coordination.
Patient Services Representative
ResMed
05.2022 - 12.2023
- Verified insurance benefits and authorizations for CPAP/BiPAP equipment and DME.
- Educated patients on coverage details, resupply schedules, and billing inquiries.
- Handled 80+ daily inbound calls, documenting issues and resolutions in Salesforce CRM.
- Maintained KPI standards for productivity, call resolution, and documentation accuracy.
Front Desk Assistant (Temp)
San Antonio Eye Center
San Antonio
06.2021 - 08.2021
- Coordinated insurance verification, prior authorizations, and appointment scheduling for ophthalmology procedures.
- Processed patient copayments and posted daily receipts while performing cash reconciliations.
- Reduced wait times by streamlining eligibility checks and intake documentation.
EVV Representative
APlus Family Care
08.2018 - 05.2021
- Reconciled electronic visit verification data to ensure Medicaid billing compliance.
- Supported care coordination by validating authorizations and scheduling home health services.
Certified Nursing Assistant
Four Seasons Home Health
10.2017 - 03.2018
- Verified insurance and assisted patients with intake forms and durable medical equipment education.
- Collaborated with nursing staff to ensure proper service authorization and patient care.
Payroll Coordinator / Scheduling Assistant
Girling Home Health
01.2016 - 03.2017
- Managed caregiver timesheet approvals and aligned shift schedules with authorized care plans to ensure compliance and accurate service delivery.
- Verified hours against Medicaid authorizations to streamline payroll processing and prevent delays.
Education
Massage Therapy -
Academy for Massage
San Antonio, TXSkills
- Patient Access & Scheduling
- Patient registration
- Patient Intake Process
- Insurance Verification & Eligibility
- Prior Authorizations
- Payment reconciliation
- EOB COB SOB
- Revenue Cycle Management
- EHR systems
- HIPAA Compliance
- Call center operations
- KPI tracking
- Staff Training
- Customer service
- Time management
- Patient Interaction
- Patient advocacy
- Medical coding
Certification
- HIPAA Compliance Training
- CPT/ICD-10 Coding (On-the-Job)
- Prior Authorization Specialist Training
Timeline
Patient Access Specialist
Hummingbird Healthcare
01.2025 - Current
Prior Authorization Specialist
Florida Blue
01.2024 - 05.2025
Patient Services Representative
ResMed
05.2022 - 12.2023
Front Desk Assistant (Temp)
San Antonio Eye Center
06.2021 - 08.2021
EVV Representative
APlus Family Care
08.2018 - 05.2021
Certified Nursing Assistant
Four Seasons Home Health
10.2017 - 03.2018
Payroll Coordinator / Scheduling Assistant
Girling Home Health
01.2016 - 03.2017
Massage Therapy -
Academy for Massage