Summary
Overview
Work History
Education
Skills
Timeline
Generic

MARIA L ORTIZ SOTO

Palm Bay

Summary

Dynamic Patient Access Specialist II at Orlando Health Melbourne Hospital with proven expertise ER registration and exceptional customer service, while ensuring patient satisfaction and confidentiality maintaining compliance with HIPAA regulations. Meticulous attention to detail. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

15
15
years of professional experience

Work History

PATIENT ACCESS SPECIALIST II

ORLANDO HEALTH MELBOURNE HOSPITAL
02.2014 - Current
  • Provided exceptional customer service, addressing patient concerns promptly and professionally.
  • Pre and Full registration on patients receiving ER services at Melbourne ER Department. Collaborated with nurses according to Hospital Guidelines, depending level of severity on patients conditions.
  • Assisted House Supervisor on hospital transfers/direct admit registration on patients arriving from different Acute Hospitals Facilities and other etc.
  • Collected, Updated patient information, emergency contact, primary physician and other pertinent information required to facilitate patient care.
  • Obtained and Updated patients insurance information (Commercial, VA, MCR/MCD, W/C, Auto, Travelers Ins). Verified eligibility, patient benefits and /or patient financial responsibility.
  • Collection of payments according to Patient Insurance Benefits responsibilities and Self Pay patients/uninsured per ER visit/encounter. Posted payments
  • Assisted patients in understanding their financial responsibilities by explaining healthcare benefits, coverage limitations, and out-of-pocket costs clearly and concisely.
  • Safeguarded patient confidentiality while handling sensitive information by adhering to strict HIPAA regulations and organizational privacy policies.
  • Maintained data accuracy with meticulous attention to detail.
  • Followed all company policies and procedures to deliver quality work.

PATIENT ACCOUNT SPECIALIST - CPAT

SHERLOQ SOLUTIONS - MERCHANT ASSOCIATION OF FL
01.2011 - 09.2013
  • Maintained high levels of data accuracy with meticulous attention to detail in processing insurance claims and updating patient records.
  • Expedited claim resolutions by skillfully navigating complex insurance policies, regulations, and guidelines.
  • Monitored flags and resolved urgent items with accuracy and efficiency. Worked with outside entities to resolve issues with billing, claims, and payments.
  • Contributed to departmental goals for lowering A/R days by prioritizing accounts based on aging reports, taking appropriate action steps to expedite collections or adjustments as needed.
  • Proactively identified potential issues in patient accounts, communicating with other departments as necessary to resolve discrepancies that could impact billing accuracy or timely reimbursements from insurance carriers.
  • Increased revenue recovery rates by identifying trends in denied claims, researching root causes, implementing corrective measures to prevent future occurrences accordingly.
  • Fostered strong relationships with insurance representatives to facilitate smooth communications regarding claim submissions, denials, appeals, or underpayments issues that arose during processing stages.
  • Improved cash flow by consistently meeting or exceeding collection targets through proactive account monitoring and follow-up efforts.
  • Promoted a culture of continuous improvement within the Patient Accounts team by participating in regular staff meetings, offering constructive feedback on department processes, systems, tools for achieving objectives more effectively.
  • Enhanced team productivity by sharing knowledge, best practices, and providing cross-training opportunities for colleagues in the Patient Accounts Department.
  • Safeguarded patient confidentiality while handling sensitive financial information by adhering to strict HIPAA regulations and organizational privacy policies.

Education

MEDICAL ASSISTANT (RMA) - Health Care Administration

KEISER CARRER INSTITUTE
PORT ST LUCIE, FL
08-2002

GENERAL STUDIES - SECRETARIAL SCIENCE

CARRIBBEAN UNIVERSITY
BAYAMON, PR
07-1996

SECRETARIAL SCIENCE - SECRETARY

INSTITUTO DE BANCA
CAYEY, PR
11-1990

Skills

  • Front desk operations, customer services
  • Calm and effective under pressure
  • Professionalism and ethics, exceptional communication w patients and families
  • Accuracy documenting and recording information
  • Patient registration, Insurance verification, Eligibility determination
  • Problem-solving
  • Multitasking and organization
  • Administrative and office support
  • Spanish fluency

Timeline

PATIENT ACCESS SPECIALIST II

ORLANDO HEALTH MELBOURNE HOSPITAL
02.2014 - Current

PATIENT ACCOUNT SPECIALIST - CPAT

SHERLOQ SOLUTIONS - MERCHANT ASSOCIATION OF FL
01.2011 - 09.2013

MEDICAL ASSISTANT (RMA) - Health Care Administration

KEISER CARRER INSTITUTE

GENERAL STUDIES - SECRETARIAL SCIENCE

CARRIBBEAN UNIVERSITY

SECRETARIAL SCIENCE - SECRETARY

INSTITUTO DE BANCA

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