Militza Torres
Parma,Ohio
Summary
Capable Patient Access professional well-versed in communication and team building, dedicated to providing superior support for patients in need of reliable information regarding insurance coverage, finance options and documentation requirements. Knowledgeable 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. Ready to bring 20 years of relevant work experience to the team.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Patient Access Specialist II
MetroHealth Hospital
Cleveland, Ohio
08.2020 - Current
- Make payment arrangements for patients, reimbursement
- Health care data collection
- Verify benefits
- Work on payor pre-authorization
- Contact patient from transfer center for direct admission and Life Flight
- Make sure that all information is correct before patient is admitted to unit floor.
- Scan any Medical Records that are send over from other facilities
- Work with Epic System, On base
- Experience with Caresource, Medicaid, Mits, Paramount, Availity, navinet, Buckeye, United Health Care,Tricare Military and Ohio Medicaid websites
- Answer all incoming patient phone calls
- Complete Notification and prior Authorization for all inpatient within 24 to 48 hours for all insurances
- Managed front desk operations, ensuring timely check-ins and appointment scheduling for patients.
- Corrects error on admission
- Does all direct admission and all transfers from other facilities
- Also work closely with the Financial Department doing all the inpatient who are uninsured and needed financial assistances, Charity spending accounts, and help patients apply for Medicaid assistances
- Coordinated patient admissions and insurance verification to enhance operational efficiency.
- Verified insurance coverage and obtained necessary authorizations to ensure timely billing and reimbursement.
- Obtain signatures for IM (Important message from Medicare)
- Obtain signatures for MOON (Medicare Outpatient Observation Notice) within 24 hours
- Work with UM support to make sure clinicals are send to correct area for billing processing
- Performs other related duties as assigned.
- Resolved patient billing issues in line with established guidelines.
- Obtained signatures from financial responsibility and treatment procedures from patients or guardians.
- Contacted insurance companies for patient medical billing operations.
- Prepared patient identification band and completed admissions papers.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Performed patient pre-admission, admission, transfer and discharge activities.
- Contacted patients on annual renewal dates to offer assistance.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Providing excellent customer service by promptly answering patient inquiries.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Collected and validated patient demographics and insurance information.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Trained new staff on hospital processes and procedures.
- Educated patients on importance of preventive health care and insurance coverage.
Emergency Medical Representative
Metro Health Hospital
Cleveland, OH
10.2011 - 08.2020
- Verified patient information in front desk before being seen in emergency.
- Co-pay collection and verification of insurance information.
- Scheduled present and future appointments in Epic.
- placed labs orders in Epic, answer incoming calls, and transferring incoming phone calls to providers.
- Scheduled and checking appointment for burn unit patient.
- Verified benefits, make payment arrangements for patients, reimbursement.
- Respond to trauma activation team by obtaining and verifying patient documentations.
- Complete all new patient registration for Trauma and Emergency Department.
- Process claims for work comp, motor vehicle accident, third party liability.
- Verify insurance in websites provided access.
- Prepared packages for Trauma team.
- Help to provide forms financial assistance.
- Experienced with Epic System, Caresources, Medicaid, Mits, Paramount, Buckeye, My CGS, United healthcare, Ohio Surgenet websites.
- Assisted with patients that spoke fluent in Spanish.
- Collected co-pay and cash activities for outpatient.
- Performs other related duties as assigned.
- Developed and maintained strong relationships with healthcare professionals to promote hospital services.
- Conducted effective presentations on new medical products and treatment protocols to various medical staff.
Education
Associate of Arts -
Bryant & Stratton College- Parma, Ohio
Parma, Ohio08.1998
High School Diploma -
Lincoln West High School
Cleveland, Ohio06.1996
Skills
- Financial obligation determination
- Authorization verification
- Microsoft Word, Excel
- Payment Processing
- Training coordination
- Registration, patient scheduling and admissions
- Patient Interviewing
- Team Collaboration
- Medical terminology
- Front desk operations and Customer Satisfaction
- HIPAA compliance
- Professionalism and ethics
Accomplishments
Certification -CHAA
Preceptor certified to train all new hires
Certification
- CHAA Certification every three year renew.
Languages
Spanish
Native or Bilingual
Timeline
Patient Access Specialist II
MetroHealth Hospital
08.2020 - Current
Emergency Medical Representative
Metro Health Hospital
10.2011 - 08.2020
High School Diploma -
Lincoln West High School
Associate of Arts -
Bryant & Stratton College- Parma, Ohio