Melanie Lugo-Nieves
Creedmoor,NC
Summary
In my current role as Patient Access Supervisor, I have developed strong leadership, relationship-building, training, problem-solving, and cross-functional collaboration skills while supporting both clinician and patient needs. My experience serving as a subject matter expert, leading process improvements, resolving complex concerns, and partnering closely with Clinical Services and other departments has prepared me to effectively support clinician customers and drive successful account engagement as a Clinical Account Manager.
Overview
1
1
Language
1
1
year of post-secondary education
10
10
years of professional experience
Work History
Patient Access Supervisor
CND Life Sciences
Creedmoor, North Carolina
03.2025 - Current
- Supervise and support a team of 13 employees, providing daily leadership, workflow oversight, coaching, and operational guidance.
- Oversee daily and monthly reconciliation and finalization of benefits verification and resolution of missing information necessary for timely claim processing.
- Lead onboarding and ongoing training for Patient Access Specialists, Patient Communication Specialists, and other Patient Access team members to promote accuracy, consistency, and efficiency.
- Collaborate with Clinical Services leadership, Patient Access leadership, and other stakeholders to support strategic objectives related to patient registration, benefits verification, prior authorization, and patient access.
- Create, update, and maintain policies and procedures related to Patient Access functions and workflows.
- Develop and manage team schedules while balancing staffing needs, workload, workflow, and operational coverage.
- Conduct monthly performance reviews with team members to evaluate productivity, efficiency, and overall performance.
- Assist with the design, development, and implementation of improved processes and procedures across the department.
- Serve as a subject matter expert (SME) for systems utilized by Patient Access Specialists and Patient Communication Specialists.
- Lead the buildout and implementation of new systems and workflows.
- Identify opportunities to reduce manual work, eliminate inefficiencies, and improve departmental processes.
- Investigate patient and clinician complaints, identify contributing factors, and provide guidance focused on prevention and resolution.
- Provide professional de-escalation and support for patients and clinicians experiencing frustration with Patient Access processes or performance.
Patient Access Lead
CND Life Sciences
Creedmoor, North Carolina
01.2024 - 03.2025
- Completed daily and monthly reconciliation and finalization of benefits verification and missing information.
- Provided new-hire and ongoing training to Patient Access Specialists, Patient Communication Specialists, and other CND team members as needed.
- Partnered closely with Revenue Cycle and Patient Access leadership to support strategic initiatives involving patient registration, benefits verification, and prior authorization.
- Updated and maintained Revenue Cycle policies and procedures specific to Patient Access functions.
- Provided operational coverage across Patient Access functions during scheduled and unexpected employee absences.
- Prepared and provided daily reporting to Patient Access leadership to monitor turnaround times and support timely completion of requests.
- Worked directly with Patient Access Specialists and health plans to assist patients with resolving benefit-related issues.
- Served as a resource and escalation point for complex patient access and insurance-related questions.
Patient Communication Specialist
CND Life Sciences
Creedmoor, North Carolina
03.2023 - 03.2024
- Managed inbound and outbound communications while providing prompt, efficient, courteous, and personalized service to patients and clinician customers.
- Communicated with patients and clinicians regarding benefits verification, prior authorization, pre-authorization updates, and results.
- Maintained accurate and timely documentation within company systems.
- Responded to a broad range of patient and clinician questions and inquiries.
- Collaborated with cross-functional departments to identify and resolve barriers affecting patient care.
- Communicated complex insurance and authorization information in a clear and patient-centered manner.
Office Manager/Clinic Director
Atlas Centre Chiropractic
Durham, North Carolina
02.2022 - 02.2023
- Managed daily operations of a single-doctor practice with 250+ appointments per week across a four-day work week.
- Completed insurance verification and submitted Medicare claims.
- Managed all aspects of motor vehicle accident patient care, including obtaining documentation, coordinating auto liens, and maintaining communication with attorneys and auto insurance companies.
- Coordinated collection of payments from patients, attorneys, insurance companies, and other responsible parties.
- Managed patient calls and emails, including communications involving attorneys and insurance companies.
- Prepared and organized physician schedules and supported efficient daily patient flow.
- Maintained accurate patient, collection, and office supply records.
- Supported achievement of annual collection goals of > $600,000 for a single-doctor practice.
- Prepared patients for appointments and ensured necessary information was available to support their care.
Front Office Coordinator
Pivot Physical Therapy
Raleigh, North Carolina
03.2019 - 02.2022
- Verified patient insurance benefits and obtained authorizations for services.
- Communicated insurance benefits, coverage limitations, and financial responsibilities to patients.
- Managed patient check-in and check-out processes.
- Prepared and organized schedules for four physicians/therapists.
- Contacted referred patients and maintained detailed referral tracking logs.
- Reconciled daily and weekly collections and maintained accurate financial records.
- Provided Spanish interpretation to support communication between patients and staff.
Patient Care Coordinator /Patient Referral Coordinator
GRANVILLE SPECIALTY CLINIC
Oxford, North Carolina
03.2017 - 04.2019
- Communicated directly with insurance companies to obtain authorizations and required documentation for procedures and surgeries.
- Coordinated referrals and surgical scheduling while ensuring necessary information was obtained and documented.
- Explained procedures and pertinent appointment information to patients.
- Collected surgical payments and maintained accurate financial logs.
- Translated documents and provided Spanish interpretation for physicians, nurses, staff, and patients.
- Managed patient check-in and check-out and collected copayments.
- Triaged patients and directed concerns appropriately based on clinical and operational needs.
Education
Medical Office Administration – Billing & Coding Specialist -
Vance-Granville Community College
Henderson, NC 09.2015 - 12.2016
Skills
- Patient Access Operations
- Team Leadership & Staff Development
- Process Improvement
- Policy & Procedure Development
- System Implementation
- Productivity & Performance Management
- Complaint Resolution & De-escalation
- Cross-Functional Collaboration
- Patient & Clinician Communication
- Spanish-English Interpretation
- Microsoft Office & Excel
Languages
Spanish
Native/ Bilingual
Timeline
Patient Access Supervisor
CND Life Sciences
03.2025 - Current
Patient Access Lead
CND Life Sciences
01.2024 - 03.2025
Patient Communication Specialist
CND Life Sciences
03.2023 - 03.2024
Office Manager/Clinic Director
Atlas Centre Chiropractic
02.2022 - 02.2023
Front Office Coordinator
Pivot Physical Therapy
03.2019 - 02.2022
Patient Care Coordinator /Patient Referral Coordinator
GRANVILLE SPECIALTY CLINIC
03.2017 - 04.2019
Medical Office Administration – Billing & Coding Specialist -
Vance-Granville Community College
09.2015 - 12.2016