Luz Regalado Reyes
Las Vegas,NV
Summary
Dynamic Patient Care Representative with extensive experience at Children's Heart Center, excelling in Medicaid eligibility and application processing. Proven ability to conduct thorough eligibility screenings and provide compassionate client advising, fostering positive relationships across diverse cultures. Recognized for meticulous document verification and delivering exceptional service to enhance patient access to vital resources.
Overview
23
23
years of professional experience
Work History
Patient Care Representative
Childrens heart center
Las Vegas, NV
02.2002 - Current
- Maintained up-to-date knowledge of state and federal regulations pertaining to Medicaid eligibility.
- Educate patients about the affordable care act. Including potential eligibility during open enrollment and qualifying events, assisted patients with enrollment applications and explained qualified health plans, tax credits, and health benefits.
- Review and process financial assistance applications by ensuring completeness and verifying supporting documents
- Informed applicants and families of other agencies providing useful or related assistance like low cost prescriptions,Low income health care,housing, food and other assistance when needed
- Assisted individuals with the completion of complex paperwork related to their Medicaid application process.
- Conducted initial eligibility screenings for Medicaid applicants.
- Assisted patients in applying for and completing necessary paperwork including appeals for Disability benefits through Social Security
- Maintain and review the uninsured hospital and clinic patient list by locating and verifying eligibility for Insurance or Medicaid as well as updating the patient accounts and billing insurance charges
- Maintain the uninsured hospital list by contacting patients and screening for state assistance as well as discounts.
- Maintain and review the clinic unsured list by continuous follow up and verification of Medicaid and Insurance websites for eligibility and coverage
- Check daily schedule for potential patients in need of Insurance or Financial assistance with Medical bills
- Updating patient accounts with updated demographics, Updating patient Insurance or Medicaid and billing charges out to Insurance
- Reviewed applications and supporting documents to determine applicant's eligibility for Medicaid benefits.
- Responded promptly to inquiries from applicants, providers concerning Medicaid services and eligibility
- Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
- Explained eligibility details and affordability options to patients with kindness and respect.
- Conducted interviews with applicants, explaining benefits process, and which programs were available.
- Maintained positive working relationship with fellow staff and management.
- Answered questions and responded to inquiries to deliver high level of service to patients.
- Knowledge of navigating Local Hospital websites for patient Insurance and Information
- Knowledge EVS,Availity,UHC,Culinary,HPN, All of the Medicaid MCO websites.
- Proofread documents carefully to check accuracy and completeness of all paperwork for State assistance and Insurance applications
Education
High School Diploma -
North Salinas High School
Salinas, CA06-1995
Some College (No Degree) - Software Applications Specialist
Computer Education Institute
Las Vegas NVSkills
- Medicaid eligibility
- Eligibility screening
- Application processing
- Document verification
- Client advising
- Cultural competence
- Microsoft Office
- Outlook
Languages
Spanish
Professional
Timeline
Patient Care Representative
Childrens heart center
02.2002 - Current
High School Diploma -
North Salinas High School
Some College (No Degree) - Software Applications Specialist
Computer Education Institute
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