Maritza Flores
Houston,TX
Summary
Meticulous Patient access rep #2,Ophthalmic/Medical Assistant. Capable Patient Access Representative # 2 dedicated to providing superior support for patients in need of reliable information regarding insurance coverage, finance options and documentation requirements. Well-versed in scheduling and database management functions for streamlined communication and reduced correspondence backlogs. Excels at identifying client needs and concerns to improve engagement strategies and overall service.
Overview
29
29
years of professional experience
1
1
Certification
Work History
Patient Service Representative
Solis Mammography -HCA West Houston Hospital
Houston, Texas
10.2021 - Current
- Assisted patients in filling out check-in and payment paperwork.
- Took copayments and compiled daily financial records.
- Used ERAD to schedule appointments.
- Compiled and reviewed medical charts.
- Balanced deposits and credit card payments each day.
- Reviewed daily care slips for doctors.
- Explained plans for treatment and payment options.
- Worked with patients to ascertain issues and make referrals to appropriate specialists.
- Facilitated communication between patients and various departments and staff.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Recommended service improvements to minimize recurring patient issues and complaints.
- Helped address client complaints through timely corrective actions and appropriate referrals.
- Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
- Followed document protocols to safeguard confidentiality of patient records.
- Organized patient records and database to facilitate information storage and retrieval.
- Explaining all forms like Hippa, Exam Billing Form, PHI and release of Medical Records.
- Making sure to obtained all necessary signatures on all forms needed by patients before scanning in patients file.
- Scanning, id#, insurance cards in ERAD for patient.
- Checking all documentations for patients insurance verification for copays , deductibles ,co-insurance due before services are rendered.
- At end of day,making sure copies of all forms are made for next day.
- Making sure all payments,like cash, checks, credit cards balance at the end of day,and if deposit need to be made prepare for manager or Supervisor to deposit in bank, and given before I leave.
Patient Access Representative #2
Memorial Hermann Medical Group SW Beechnut /59
Houston, TX
10.2020 - 10.2021
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
- Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
- Explained estimated cost for medical treatments and answered patient questions to promote good understanding of proposed services.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
- Facilitated communication between patients and various departments and staff.
- Worked with patients to ascertain issues and make referrals to appropriate specialists.
- Helped address client complaints through timely corrective actions and appropriate referrals.
- Followed document protocols to safeguard confidentiality of patient records.
- Recommended service improvements to minimize recurring patient issues and complaints.
- I am currently knowledgeable with Athena.net and Care 4 EMR with Memorial Hermann.
- I am also knowledgeable using Zirmed, Aviality.com , TMHP, Cigna, UHC and other websites for insurances verification and also using telephones for patient benefits and inquiries ,if needed to determined if eligible for visit or procedure, surgeries before scheduling patients.
- End of day making sure all close out for payments, like checks, cash, credit cards , balances all are done and is correct,and deposit slips given to Manager at end of day before leaving for day.
- Obtaining patients insurance cards and ID entered and scanned into systems with patients documents , that is needed to be explained and obtained patients necessary signatures before procedures or visits are preformed.
- Also good communication as customer service when answering calls, scheduling , rescheduling or confirming patients appointments in person or on the telephone.
Patient Access Rep II
Memorial Hermann Medical Group -TMC
Houston, TX
01.2019 - 03.2020
- Obtaining demographic insurance and financial information from patients or guarantor
- Entering all information in computer systems in a accurate and timely matter
- Explaining all required forms to patients or guarantor and obtaining all necessary signatures
- Insuring medical necessities compliance by obtaining necessary data reviewing compliance system , communicating all information to patients or guarantor , obtaining all necessary signatures
- Protecting financial intregarities of facility by collecting patients liability , stabilized payment arrangement , discussing payment options screening for eligibility
- Balanced deposits and credit card payments each day
- Compiled and reviewed medical charts
- Reviewed and corrected claim errors to facilitate smooth processing
- Used [Athena.net] to schedule patient appointments
- Used Care 4 for messages and compiling labels and appointments for physicians, medical assistant, and for patients documentation of medical history , medication refills from pharmacies and patient request
- Answering 30 to 50 calls daily with Cisco utility System, and returning all calls by end of day
- I am currently using Aviality.com and Zirmed and UHC, TMHP website for verification for insurance as well as other websites for patient eligibility and also obtaining referrals for office visits or procedures.
- Maintained HIPAA compliance across all patient data-handling, systems and training
- Maintained strict patient privacy and confidential patient information, taking care to meet all HIPAA guidelines and statues for data security
- Accessed patient information through variety of office software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations
- Developed and maintained quality care systems and standards, including creating and improving medical protocols and guidelines
- Scheduled and confirmed patient appointments with patients and healthcare professionals
- Utilized customer service skills and detailed system knowledge to support hospital and clinic operations
- Liaised with medical care professionals and community organizations to ensure residents suffering from chronic disease-related symptoms received adequate care
- Communicated extensively with patients to provide assistance, support and instructions
- Checked daily doctor schedules and verified insurance
- Making sure all credit card,checks,cash payments at end of the day balance out, and deposit slips are done and given to supervisor or manager by end of day before i leave.
Contact Lens Manager-Tech/Medical Receptionist
Eye To Eye Vision Center/Optometrist
The Bronx, NY
09.1990 - 03.2005
- Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing.
- Organized paperwork such as charts and reports for office and patient needs.
- Maintained current and accurate medical records for over 15 years for patients.
- Managed master calendar and scheduled appointments for 3 providers based on optimal patient loads and clinician availability.
- Enhanced office efficiency by handling 60+ callers per day.
- Completed skilled administrative work to support all office staff and operational requirements.
- Adeptly managed multi-line phone system and pleasantly greeted all patients.
- Obtained payments from patients and scanned identification and insurance cards.
- Checked patient data including insurance, demographic and health history to ensure all information was current.
- Scheduled, rescheduled and handled cancelled appointments for patients.
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Managed office logistics by scheduling appointments, maintaining files and collecting payments.
- Adhered to strict HIPAA guidelines at all times to protect patient privacy.
- Responded to correspondence from insurance companies to verify patient's coverage, and make sure all referrals are obtained for office visits or procedures.
- Promptly answered multi-line phone system and greeted callers enthusiastically.
- Received, recorded and addressed incoming and outgoing communication via telephone and email.
- Frequently double-checked patient histories and current information while scheduling follow-ups and other appointments.
- Maintained office supplies inventory by checking stock and ordering new supplies as needed.
- Contacted hospitals to confirm patients medical histories and prevent inaccurate diagnoses and treatments.
- Located, checked in and pulled medical records for patient appointments and incomplete charts.
- I also trained patients for contact lenses and also instructed them in care and removal.
- I also make sure all cash, credit cards , checks, all money corresponded with balance at end of day and make sure i gave to supervisor before i left at end of day.
Bilingual Ophthalmic/Medical Assistant
The Robert Cizik Eye Clinic – TMC
Houston, TX
04.2010 - 01.2019
- Supported duties for diagnostic and technical treatment procedures, such as setting up and operating special medical equipment and apparatus
- Reported any unusual or urgent circumstances in patients' condition or environment immediately to supervisor or manager
- Implemented care and efficiency improvements to support and enhance office operations
- Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment
- Performed clerical duties, such as word processing, data entry, answering phones and filing
- Maintained detailed records of test results by entering data and patient information into computer
- Updated inventory, expiration and vaccine logs to maintain current tracking documentation
- Enhanced patient outcomes by providing knowledgeable education on procedures, medications and other physician instructions
- Explained procedures to patients to reduce anxieties and increase patient cooperation
- Conducted monthly and quarterly inventory of supplies using facility cost reporting records
- Collected and documented patient medical information such as blood pressure and weight
- Prepared and administered medications to alleviate patient symptoms
- Oriented and trained new staff on proper procedures and policies
- Promoted office efficiency, coordinating charts, completing insurance forms and helping patients with diverse needs
- Obtained client medical history, including medication information, symptoms and allergies
- Prepared initial patient charts for admission
- Obtained accurate medical histories from patients, highlighting critical information
- Scheduled and accompanied clients to medical appointments
- Submitted prescriptions to pharmacy via phone, fax or web
- Called and faxed pharmacies to submit prescriptions and refills
- Sanitized, restocked and organized exam rooms and medical equipment
- Arranged surgeries with surgical center, confirming times with patients and preparing admission and consent forms
- Gathered forms, copied insurance cards and identification cards to collect patient information for billing and insurance filing, and also obtaining referral and pre -certification for visit or procedures for surgery for the visit.
- Educated patients by providing medication and diet information and clarifying physicians' orders, answering questions thoroughly
- Report significant information and changes in patient condition to nurse supervisor
- Ordered and prepared reagents and supplies
- Communicated clearly and effectively with patients to verify information, determine purpose of visit and record medical history
- Scheduled appointments, registered patients and distributed sample pharmaceuticals as prescribed
- Escorted patients to examination rooms
- Documented all maintenance and repairs in timely fashion
- Offered age-appropriate patient care before, during and after exams
- Compiled necessary documents for surgical billing packages
- Attended required training, education and meetings
- Entered patient, procedure and equipment into computer system
- Checking in and checking out patients and collecting copays ,and deductible, co-insurance
- Entering and making sure patient get a receipt for all payments made
- Making sure all cash, credit card, checks balance out for the day, and deposit slips are done and given to the supervisor or manager at the end of the day
Bilingual Ophthalmic/Medical Receptionist
Medical Center Ophthalmology-TMC- St. Lukes Towers
Houston, Texas
02.2007 - 02.2010
- Interacted with all necessary partners throughout establishment including physicians, nursing staff, technicians, and medical assistants
- Performed monthly inventory and maintained office and medical supply counts
- Interviewed patients to obtain medical information, weight and height measurements and vital signs
- Assessed patients and documented their medical histories
- Maintained good communication between department heads, medical staff and governing boards by attending board meetings and synchronizing interdepartmental functions
- Verifying insurances, obtaining referral , AR, posting charges, following up on claim payment and status
- Working up patients , vision testing, dilating patient eyes, getting them ready for Ophthalmologist
- Scheduling and rescheduling patients surgeries, getting physician orders, consent and paper work ready for facility
- Preparing patients for surgery, and post op follow ups , also go over procedure care before and after surgery, patient may be given a care kit before and after surgery
- Also making sure closeout of cash,credit cards,checks for daily log balance out , and deposit slip is made and given to manager, or supervisor, before leaving for the day
Education
Certification - medical assistant
Professional Careers Institute
Houston,Tx02.2006
Certification - Word Processing
Haussman Computer School
The Bronx, NY06.1990
High School Diploma -
Theodore Roosevelt High School
Bronx, NY1983
Skills
- Document scanning
- Interpersonal and written communication
- Clerical support
- Self-motivated
- Strong verbal communication
- Skilled in microsoft office
- Extremely organized
- Data entry
- Information Collection
- EMR
- Medical terminology
- Insurance Verification
- Appointment Scheduling
- Document filing
- Fee Collection
Certification
Graduate Certification in Medical Assistant,CPT,CET, in the year 2006, all certifications are current
Timeline
Patient Service Representative
Solis Mammography -HCA West Houston Hospital
10.2021 - Current
Patient Access Representative #2
Memorial Hermann Medical Group SW Beechnut /59
10.2020 - 10.2021
Patient Access Rep II
Memorial Hermann Medical Group -TMC
01.2019 - 03.2020
Bilingual Ophthalmic/Medical Assistant
The Robert Cizik Eye Clinic – TMC
04.2010 - 01.2019
Bilingual Ophthalmic/Medical Receptionist
Medical Center Ophthalmology-TMC- St. Lukes Towers
02.2007 - 02.2010
Contact Lens Manager-Tech/Medical Receptionist
Eye To Eye Vision Center/Optometrist
09.1990 - 03.2005
Certification - medical assistant
Professional Careers Institute
Certification - Word Processing
Haussman Computer School
High School Diploma -
Theodore Roosevelt High School
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