MELY ROSE PASCUA
HENDERSON,NV
Summary
Enthusiastic about helping patients get necessary medical support by obtaining authorizations, scheduling procedures and coordinating paperwork. Detail-oriented and proactive with good relationship-building skills, a hardworking nature and an adaptable approach. Proficient in SMS software and with over 10 years of work experience.
Overview
22
22
years of professional experience
Work History
Insurance Verification Specialist
UNIVERSAL HEALTH SYSTEMS, SUMMERLIN HOSPITAL
07.2022 - 03.2023
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Assisted patients with understanding personalized insurance coverage and benefits.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Achieved insurance pre-authorizations to enable timely patient procedures.
- Updated patient records with accurate, current insurance policy information.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Established and maintained relationships with insurance providers for productive communications.
- Generated reports to track insurance verifications and claim progress.
- Communicated verification and authorization status updates with CASE MANAGEMENT to facilitate decision-making for patient admissions and insurance coverage.
- Performed various administrative tasks by filing, copying and faxing documents.
- Organized and maintained patient chart filing system to promote quick data finding for staff.
- Obtained and managed approximately 50-60 patient authorizations per day.
Patient Services Representative
UNIVERSITY HEALTH SYSTEMS, DESERT SPRINGS HOSPITAL
04.2019 - 07.2022
- Provided exceptional customer service to patients, answering questions and addressing concerns.
- STAT ER registration
- Verified insurance eligibility and coverage for patients.
- Data entry for all ER patient demographics and insurance data into SMS and CERNER electronic medical record system.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Managed patient registration process, confirming data accuracy and completeness.
- Responsible to obtaining all signatures required for registration process.
- Built and maintained positive working relationships with patients and emergency room staff.
- Took copayments, deductibles, and or estimates via ECARE SYSTEM
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Followed document protocols to safeguard confidentiality of patient records.
- Facilitated communication between patients and various departments and staff.
- Multitasking in a fast paced work environment including answering multiple phone lines.
- Responded to inquiries by directing calls to appropriate hospital department.
- Delivered support to medical staff in completion of patient paperwork.
- Overseeing and activating all direct admits and transfers from other facilities.
- Creating authorizations for inpatient stays including VA patients via electronic insurance portals such as but not limited to HPN, UHC, and AVAILITY.
- Responsible for calling all CODE REDS via PA system for the hospital.
- Proficient with "WOW" mobile computer system.
- Responsible for placing ER patients into holding beds.
- Registered approximately 60-75 emergency room patients daily.
Patient Service Representative
Retina Institute Of Hawaii
12.2017 - 10.2018
- Provided exceptional customer service to patients, answering questions and addressing concerns.
- Verified insurance eligibility and coverage for patients.
- Entered patient demographic and insurance data into electronic medical record system.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Managed patient registration process, confirming data accuracy and completeness.
- Built and maintained positive working relationships with patients and staff.
- Took copayments and compiled daily financial records.
- Assisted patients in filling out check-in and payment paperwork.
- Handled customer service inquiries in person, via telephone and through email.
- Balanced deposits and credit card payments each day.
- Answered incoming calls, scheduled appointments and filed medical records.
- Verified patient insurance eligibility and entered patient information into system.
- Provided excellent customer service to patients and medical staff.
- Greeted and assisted patients with check-in procedures.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Responded to inquiries by directing calls to appropriate personnel.
- Facilitated communication between patients and various departments and staff.
- Organized patient records and database to facilitate information storage and retrieval.
- Scheduled initial and follow up appointments via CENTRICITY program.
Receptionist Clerk/Patient Service Representative
UCERA
10.2016 - 12.2017
- Provided exceptional customer service to patients, answering questions and addressing concerns.
- Verified insurance eligibility and coverage for patients.
- Entered patient demographic and insurance data into electronic medical record system.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Managed patient registration process, confirming data accuracy and completeness.
- Built and maintained positive working relationships with patients and staff.
- Took copayments and compiled daily financial records.
- Assisted patients in filling out check-in and payment paperwork.
- Used EPIC program to schedule appointments.
- Balanced deposits and credit card payments each day.
- Answered incoming calls, scheduled appointments and filed medical records.
- Verified patient insurance eligibility and entered patient information into system.
- Provided excellent customer service to patients and medical staff.
- Greeted and assisted patients with check-in procedures.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Followed document protocols to safeguard confidentiality of patient records.
- Responded to inquiries by directing calls to appropriate personnel.
- Facilitated communication between patients and various departments and staff.
- Delivered support to medical staff in completion of patient paperwork.
- Compiled and maintained patient medical records to keep information complete and up-to-date.
- Resolved customer complaints using established follow-up procedures.
- Worked with patients to ascertain issues and make referrals to appropriate specialists.
- Proficient with EPIC system
Medical Office Assistant
HAWAII EAR CLINIC
01.2013 - 04.2015
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Updated patient information and insurance details for accurate electronic medical records.
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Prepared patient charts by gathering and organizing medical records ahead of appointments.
- Used GREENWAY program to schedule appointments for doctor visits and procedures.
- Registered patients and completed associated paperwork for accurate records.
- Gathered forms and copied insurance cards to collect patient information for billing and insurance filing.
- Obtained pre-authorization from insurance companies ahead of medical services.
- Restocked each medical room with adequate supply of medications and supplies in preparation for patients.
- Received, recorded and filed medical payments by check, cash, and credit card.
- Reconciled daily payments received.
- Performed various administrative tasks by filing, copying and faxing documents.
- Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
- Greeted and interacted with patients to provide information, answer questions and assist with appointment scheduling.
- Obtained payments from patients and scanned identification and insurance cards.
- Completed administrative patient intakes with case histories, insurance information and mandated forms.
- Placed new supply orders, managed inventory and restocked clerical spaces.
- Prepared and processed patient referrals.
- Organized and maintained patient chart filing system to promote quick data finding for staff.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Registered and verified patient records before triage with most up-to-date information.
- Received and routed laboratory results to correct clinical staff members.
- Frequently double-checked patient histories and current information while scheduling follow-ups and other appointments.
- Greeted visitors and initiated triage processes for clients to streamline patient flow.
- Maintained and cleaned exam rooms
- Disposed medical waste
- Properly disinfected all medical equipment and tools used by clinical staff.
- Assisted Neuro otologist with exam when warranted.
Massage Therapist
Self Employed
01.2013 - 04.2015
- Developed and maintained positive relationships with clients through professional communication and follow-up to increase satisfactions and build rapport.
- Created comfortable and professional environment for clients by setting up massage tables and preparing treatment area.
- Provided safe, effective, and appropriate massage therapy techniques during customer appointments.
- Booked appointments, answered phones, greeted clients, handled payments, and created client service tickets.
- Assessed medical histories and conditions of clients to determine contraindications to massage services.
- Researched new techniques to stay up to date with trends and developments in massage therapy industry.
- Utilized deep tissue, Swedish and myofascial massage therapy techniques to provide options to customers.
- Demonstrated knowledge of anatomy and physiology to better understand body and inform massage techniques.
- Assisted clients in understanding benefits of massage therapy to provided education on self-care techniques.
- Evaluated client conditions to recommend appropriate massage therapy methods.
- Offered aromatherapy, hot stones and cupping as part of massage treatments.
- Maintained client treatment records and designed long-term care programs for return customers.
- Provided clear, concise instructions to clients to prepare for massage services.
- Collaborated with physical therapists and other medical professionals to provide holistic care.
- Registered and managed case files, detailed notes and progress on database to enable tracking history and maintain accurate records.
- Provided custom massage treatments to clients, tailored to individual needs and preferences.
- Educated clients on benefits of massage and recommended home care techniques.
- Assessed guest needs and identified muscle issues, medical conditions, and contraindications before beginning session.
- Prepared oils and lotions for massages.
- Administered Swedish, deep tissue and sports massage techniques.
- Maintained accurate and up-to-date client records.
- Researched new massage techniques and treatments.
- Performed aroma therapies and specialized relaxation techniques.
- Performed sanitization tasks to keep massage environment clean and safe.
- Developed customized massage programs to meet unique requirements.
Registration/Appointment Receptionist
KAISER PERMANENTE, HONOLULU CLINIC
10.2000 - 11.2003
- Sorted, received, and distributed mail correspondence between departments and personnel.
- Confirmed appointments, communicated with clients, and updated client records.
- Welcomed customers with friendly greeting, answered general questions, gathered nature of visit and directed to specific offices.
- Organized, maintained and updated information in computer databases.
- Operated multi-line telephone system to answer and direct high volume of calls.
- Assisted internal staff with clerical and administrative needs to maximize efficiency and team productivity.
- Collected and distributed messages to team members and managers to support open communication and high customer service.
- Routed incoming mail and messages to relevant personnel without delay.
- Assisted patients in filling out check-in and payment paperwork.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Entered patient demographic and insurance data into electronic medical record system.
- Managed patient registration process, confirming data accuracy and completeness.
- Provided exceptional customer service to patients, answering questions and addressing concerns.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Built and maintained positive working relationships with patients and staff.
- Answered incoming calls, scheduled appointments and filed medical records.
- Provided excellent customer service to patients and medical staff.
- Followed document protocols to safeguard confidentiality of patient records.
- Greeted and assisted patients with check-in procedures.
- Responded to inquiries by directing calls to appropriate personnel.
- Organized patient records and database to facilitate information storage and retrieval.
Education
Certificate of Competence - Massage Therapy
Kapiolani Community College/University of HI Community Colleges
Honolulu, HI04.2009
Certificate of Completion - Cosmetology / Aesthetics
Honolulu Community College
Honolulu, HI05.2008
High School Diploma -
Governor Wallace Rider Farrington High School
Honolulu, HI06.1997
Skills
- Organization and Time Management
- Insurance Terminology
- Payment Scheduling and Collection
- Prior Authorization Processing
- Computer Proficiency
- Data Verification
- Document Management
- Insurance Plan Verification
- Data Integrity
- Medical Records Verification
- Insurance Authorizations
- Medical Terminology
Professional References
NICOLE KAMEKONA 808-486-3277 HAWAII EAR CLINIC- OFFICE MANAGER
SHEILA ROBINSON 702-513 8564 DESERT SPRINGS HOSPITAL- ADMITTING MANAGER
MELANIE DUQUE 702-557-1376 DESERT SPRINGS HOSPITAL - ADMITTING SUPERVISOR
MARLENE LOPEZ 702-824-0350 ST, ROSE SIENA CAMPUS- PATIENT SERVICE REPRESENTATIVE
Timeline
Insurance Verification Specialist
UNIVERSAL HEALTH SYSTEMS, SUMMERLIN HOSPITAL
07.2022 - 03.2023
Patient Services Representative
UNIVERSITY HEALTH SYSTEMS, DESERT SPRINGS HOSPITAL
04.2019 - 07.2022
Patient Service Representative
Retina Institute Of Hawaii
12.2017 - 10.2018
Receptionist Clerk/Patient Service Representative
UCERA
10.2016 - 12.2017
Medical Office Assistant
HAWAII EAR CLINIC
01.2013 - 04.2015
Massage Therapist
Self Employed
01.2013 - 04.2015
Registration/Appointment Receptionist
KAISER PERMANENTE, HONOLULU CLINIC
10.2000 - 11.2003
Certificate of Competence - Massage Therapy
Kapiolani Community College/University of HI Community Colleges
Certificate of Completion - Cosmetology / Aesthetics
Honolulu Community College
High School Diploma -
Governor Wallace Rider Farrington High School
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