Maria Avelar
San Diego,CA
Summary
As an experienced Provider Support Coordinator with a passion for healthcare, I have spent the past nineteen years contributing to positive organizational outcomes through effective management, strong leadership, coachable attitudes, and exceptional problem-solving skills. My expertise includes providing training and assistance for the Rev/Cycle systems, such as Epic, All Scripts, Quest, Signature, TDS, and IDS, with a keen desire to learn and consistently exceed expectations. I possess a comprehensive understanding of Microsoft Office tools, including Word, Excel, Power Point, Outlook, and SharePoint, and am proficient in Epic modules 2017-2022, making me a valuable asset in the UC Administrative industry.
As a dedicated and knowledgeable customer service professional, I am adept at developing relationships, cultivating partnerships, and growing businesses. My articulate, energetic, and results-oriented approach has allowed me to excel in this industry, and I am confident in my ability to continue delivering exceptional results in future roles. Thank you for your consideration.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Practice Support Coordinator
UCSD Health
05.2023 - Current
- Worked with other departmental staff to answer questions and resolve problems.
- Maintained and verified accuracy of records and generated miscellaneous reports.
- Coached employees through day-to-day work and complex problems.
- Prepared employee schedules for maximum coverage during key hours.
- Provide leadership and training for all front and back-end duties such as rooming patients, Epic workqueue coaching, and other advanced administrative duties.
- Created Standard of Work throughout the department
- Creates and maintains staff scheduling, participates in timecard preparation and creates and maintains monthly and ad hoc reports
- Delegated tasks to staff members, monitored completion of all duties and provided support to enhance performance.
- Delivered effective onboarding and training to new and existing employees and cross-trained staff members in other job roles to maximize coverage.
- Communicated with patients, asked appropriate questions and employed active listening to determine best care.
- Built relationships with physicians to create steady referral pipeline.
- Monitored number of patients and wait times to create efficient flow of patients from check-in to check-out.
- Experience in Tableau reports and Excel
- Completed bi-weekly payroll for 15 employees.
- Created and managed the schedules of 42 providers using edit template
- Oversaw Durable Medical Supply (DME) authorization requests
Call Center Specialist
UC San Diego Healthcare
11.2021 - 05.2023
- Develop rapport & constructive working relationship with all internal & external customers
- Follow procedures, scripts to meet expected results while ensuring warm personable relationship is being developed
- Answering incoming calls over 30 calls per hour using multi-phone lines
- Exercise independent judgement & effective critical thinking skills
- Assist with incoming mail delivery
- Assist with new hire training, training program, and assist with processes
- Triage all calls and transfer to appropriate staff
- Attends department meetings
- Directs patients to waiting areas/Obtains relevant information to determine priority appointment time/date, confirms appointment changes due to cancellations.
- Refers patients that need financial assistance to Financial Coordinator.
- Knowledgeable in HIPAA Compliance regulations
- Carried out day to day duties accurately and effectively.
- Frequently attend educational seminars to improve knowledge and performance level
- Advanced conflict resolution skills, with ability to deescalate volatile situations and challenging patients on-site and in real-time in effort to minimize further escalation
- Administrative Staff Supervision
Patient Service Representative
Scripps Clinic
09.2019 - 11.2021
- Knowledgeable with insurance billing, coding & claim appeals
- Scheduling procedures, ultrasounds, new patient appointments
- Scheduling Rep Meetings
- Surgery Scheduling
- Develop rapport and constructive working relationship with all internal and external customers
- Follow procedures and scripts to meet expected results while ensuring warm personable relationship is being developed
- Knowledgeable in Excel spreadsheet
- Answering incoming calls, outgoing, using multi-phone lines
- Prior Authorization management
- Exercise independent judgment and effective critical thinking skills
- New patient registration
- Assist with incoming mail delivery
- Organize front office procedures and processes
- Provide and assist administrative support for 8 physicians
- Collect and scanning OB charge sheets
- Communicates with Telecommunications to ensure proper function of telecommunication devices in unit
- Completes EDD Claims for department
- Triage all calls and transfer to appropriate staff
- Experience with scheduling AFI/NST with Perinatology, entering orders, and prior authorizations for department
- Ensures appropriate ordering of office supplies
- Experience printing patient labels and wristbands
- Chaperoned patient appointments when requested
- Attends meetings, takes meeting minutes, and prepares and distributes meeting minutes
- Assisted patients in filling out check-in and payment paperwork
- Took copayments and compiled daily financial records
- Balanced deposits and credit card payments each day
- Explained plans for treatment and payment options
- Facilitated communication between patients and various departments and staff
- Helped address client complaints through timely corrective actions and appropriate referrals
- Offered simple and clear explanations to help clients and families understand hospital policies and procedures
- Recommended service improvements to minimize recurring patient issues and complaints
- Taught patients and families to use at-home medical equipment
- Interdepartmental functions Coordination
- New Employee Orientation, processes, and created updated training program
- Coordinated special events held within department
- Compliance Advisory
- Employee work scheduling including breaks and lunches; Along with annual training courses
- Provided invoice statements to manager and director
- Clerical support in any department needed for front and back office staff
- Ability to lead and successfully resolve workforce concerns and issues
- Involvement and demonstrated ability to participate in recruitment process
- Possess skills and extensive knowledge of practices in Ambulatory setting, administrative lead, and front office administration
Cadence Go-Live Lead Support
Optimum Health IT
03.2018 - 09.2019
- Update curriculum and supplemental materials based on workflow changes and improvement within various ambulatory departments
- Facilitates New Hire Training for ambulatory clinical staff across healthcare system
- Review OneApp requests for new hires and assign appropriate learning track in Torch LMS
- Answer training related help desk tickets in Service Desk App
- Demonstrated respect and friendliness to help wherever needed
- Worked flexible hours; nights, weekends, and holiday shifts
- Followed up with clients to verify optimal customer satisfaction following support engagement and problem resolution
- Proved successful working within tight deadlines and fast-paced atmosphere
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
- Demonstrated respect, friendliness and willingness to help wherever needed
- Performed duties in accordance with applicable standards, policies, and regulatory guidelines to promote safe working environment
- Maintained energy and enthusiasm in fast-paced environment
Senior Patient Services Coordinator
UC Irvine Healthcare
11.2004 - 03.2018
- Answers calls and relays messages to staff
- Handled high volume of incoming and outgoing calls over 80 calls per hour while meeting high monthly goals
- Experience working with TDS, Signature, IDS, MS Office, EPIC and QUEST system
- Analyze raw data and draw conclusions based on findings during investigation
- Directs patients to waiting areas
- Obtains relevant information to determine priority appointment time/date, confirms appointment changes due to cancellations and notifies patients of available alternate times, schedules/registers for follow up appointments, tests and procedures
- Refers patients that need financial assistance to Financial Counselor
- Maintains accurate information and utilizes various software, including department specific programs, to schedule, enter charges, find and scan documents, and accurately enter patient information
- Ensures current schedules are accurate, makes authorized changes as appropriate
- Verifies member's benefits, notifies member of applicable cost share and updates patients' demographics information to include all patient registration and billing information
- Provided patient with after-visit summary and scheduled next appointment to maintain continuous care and facilitate treatment plan
- Telephoned and interviewed patients and family members to obtain pre-registration information and confirm appointments.
- Oversaw monthly inventory orders to guarantee properly stocked office
- Collected forms, insurance card, and co-pay to facilitate registration process, and prepare patient for appointment.
- Called patient to confirm appointment and prepared paperwork prior to visit to expedite check-in process
- Respected patients by recognizing rights and maintaining confidentiality
- Verified patient availability during appointment scheduling process to reduce reschedules and cancellations.
- Communicated with primary care offices and insurance companies to obtain authorization.
- Escalate any issues as appropriate
- Performs related clerical duties as required, such as direct booking, and copying
- Performs related clerical duties in support of Clinic Strategic Goals and Proactive Office
- Encounters Assist in orienting new employees
- 13 years of Call Center experience
- Knowledgeable in HIPAA Compliance regulations Carried out day-to-day duties accurately and effectively
- Worked flexible hours
- Assists with inventory control procedures
- Obtains copies of patient's insurance card(s) and ID
- Updates and maintains all necessary logs
- Oversaw monthly inventory orders to guarantee properly stocked office
- Data entry and retrieval
- Handled incoming internal messages and re-route to appropriate department
- Developed team meetings to boost department morale
- Contacted insurance company to verify patient coverage before visit.
- Demonstrated exceptional customer service to foster welcoming and professional environment for patients
- Collaborated with colleagues to maintain and upkeep office and waiting area to provide clean and organized environment for patients.
- Clerical Support in any department needed in front and back office
- Experience with education/training on complaints and grievances process in complex healthcare organization
- Advanced conflict resolution skills, with ability to deescalate volatile situations and challenging patients on-site and in real-time in effort to minimize further escalation.
- Proven ability to serve as point of contact and work collaboratively as team member/leader.
Sales Associate
JC Penny’s
01.2003 - 11.2004
- Processing purchases, and handling returns and other discrepancies
- Organized racks and shelves to maintain store visual appeal, engage customers and promote specific merchandise.
- Provided positive first impressions to welcome existing, new and potential customers.
- Increased sales by offering advice on purchases and promoting additional products.
- Processed product returns and assisted customers with other selections.
- Achieved perfect attendance and on-time record.
- Cash handling experience and credit/debit card processing
- Engaged with customers to effectively build rapport and lasting relationships
- Prepared merchandise for sales floor by pricing or tagging
- Organized racks and shelves to maintain store visual appeal, engage customers and promote specific merchandise
- Helped customers locate products and checked store system for merchandise at other sites
- Implemented up-selling strategies such as recommending accessories and complementary purchases to boost revenue.
- Educated clients on current promotional offerings and products using persuasive selling tactics
Practice Support Coordinator
UCSD Pulmonary And Sleep Center
05.2023 - Current
- Increased efficiency by streamlining coordination processes and implementing new organizational systems.
- Managed project timelines for successful completion, ensuring milestones were met and deadlines were adhered to.
- Improved team productivity with regular communication and progress updates, fostering a collaborative work environment.
- Coordinated cross-functional teams, resulting in seamless project execution and enhanced outcomes.
- More than 5 years of experience working in a Multi-Specialty clinic setting.
- Experience and proven success in skills to supervise support staff in clinic / center administration, and effectively manage multiple priorities in a fast-paced, dynamic environment.
- Detail oriented, with the ability to apply analytical and critical thinking skills to quickly analyze problems, determine appropriate level of intervention, and apply effective solutions.
- Solid interpersonal skills for effective information exchange and problem solving with all levels of management and staff, consultants, and outside agencies.
- Knowledge or experience with Daily Engagement System (DES)
- Proven experience creating and managing staff schedules.
- Enhanced customer satisfaction with timely responses to inquiries and effective resolution of issues.
- Fostered a positive work environment by promoting teamwork, open communication, and ongoing professional development opportunities.
- Maintained compliance with industry regulations through thorough documentation, reporting, and training initiatives.
- Managed day-to-day operations of the clinic to ensure seamless service delivery for patients and staff members alike.
- Collaborated with healthcare providers to develop tailored care plans that addressed individual patient needs effectively.
- Evaluated employee performance regularly, providing constructive feedback and setting achievable goals for continued growth and development.
- Ensured strict adherence to confidentiality protocols regarding sensitive patient information in line with HIPAA regulations.
- Monitored duties assigned to personnel to promote high levels of patient care and job efficiency.
- Monitored number of patients and wait times to create efficient flow of patients from check-in to check-out.
- Conducted frequent clinic walk-throughs to maintain safe work environment.
- Enforced maintenance of clean and organized work environment in compliance with safety and sanitation regulations.
- Attended regular meetings with hospital administrators to discuss clinic operations and policies.
- Liaised with health insurance companies to process insurance claims and maximize reimbursements.
- Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
- Boosted clinic''s reputation, establishing relationships with local healthcare providers and organizations.
- Responsible for anticipating potential scheduling problems.
- Coordinates recruitment, interview meetings for potential candidates.
- Review required reports with manager for staffing follow-up.
- Ensures No-Show Policies and Procedures are followed.
- Routinely confirms and / or updates demographic and insurance verification.
- Follows late patient policy / department specific.
- Ensures adequate front office staffing and assists if necessary.
- Reviews and implements bump and wait lists / department specific.
- Completes the registration for advance registered or previously registered patients, timely and accurately.
- Interviews patients both in person and via telephone to obtain personal data and financial / insurance information.
- Prior to the patient receiving services, ensures the patient's UCSD identification card is accurate and valid.
- Verifies insurance for HMO / PPO / Federal & State programs and obtains eligibility for outpatient services.
- Utilizes various automated eligibility systems to obtain appropriate eligibility information.
- Requests prepayment and co-pays as required based on specific collection standards and the Financial policy.
- Prepares cash receipt; processes payments in a timely manner according to the standards.
- Utilizes funding notes to communicate pertinent financial information to case managers, patient service representatives, finance and admissions staff.
- Ensures authorization obtained and linked prior to appointment if needed.
- Seeks knowledge and skills appropriate to the practice setting by attending educational workshops, seminars, and classes to enhance knowledge and skills.
- Participate in Trainings as required by Ambulatory Care and / or Medical Center / Medical Group.
- Tracks all inventory
- Liaison between Payroll departments in resolving time keeping and paycheck issues.
- Monitors overtime and breaks and immediately addresses any issues to manager.
- Monitors time keeping in accordance with department policy.
- Monitors and maintains time off requests.
- Requests for float coverage as required.
- Respects the dignity, privacy and cultural values of all individuals
- Experience with Tableau & Excel.
- Knowledge of third-party payors including federal, state and private health plans.
- Experience creating reports and/or presentations for senior leadership
- Extensive experience working in EPIC, including reporting and dashboard management
- Experience working with grieving families.
- Green belt in Lean Six Sigma.
- Established clear expectations for team members, fostering a positive work environment through open communication and accountability.
- Resolved conflicts between employees swiftly and professionally, maintaining a harmonious workplace atmosphere conducive to collaboration.
- Completed bi-weekly payroll for 14 employees.
Education
High School Diploma -
Villa Park High School
Villa Park, CA07.2002
Skills
- Types 85wps
- Proficient in MS Office
- Strong team working
- Punctual
- Calm and Professional Under Pressure
- Responding to Difficult Customers
- Understanding Customer Needs
- Call Center Processes
- Efficient and Detail-Oriented
- Building Customer Trust and Loyalty
- Patient and Empathetic
- Collaboration skills
- Interpersonal skills
- Organization and proficiency skills
- Problem solving skills
- Time management skills
- Computer proficiency skills
- Social Media Skills
- Customer Service Skills
- Adaptability and flexibility skills
- Commercial Awareness skills
- Informative Announcements
- Employee Performance Evaluations
- Healthcare Laws and Regulations
Certification
Lean Six Sigma Yellow Belt
Timeline
Practice Support Coordinator
UCSD Health
05.2023 - Current
Practice Support Coordinator
UCSD Pulmonary And Sleep Center
05.2023 - Current
Call Center Specialist
UC San Diego Healthcare
11.2021 - 05.2023
Patient Service Representative
Scripps Clinic
09.2019 - 11.2021
Cadence Go-Live Lead Support
Optimum Health IT
03.2018 - 09.2019
Senior Patient Services Coordinator
UC Irvine Healthcare
11.2004 - 03.2018
Sales Associate
JC Penny’s
01.2003 - 11.2004
High School Diploma -
Villa Park High School