Monique Paez
San Jose,CA
Summary
Diligent and personable professional with a strong ability to identify customer needs and present value-driven solutions that contribute to revenue growth. Skilled in developing effective strategies, managing customer relationships, and resolving disputes. Committed to providing exceptional customer service while achieving business objectives. Results-driven individual with substantial experience in customer service and sales, consistently meeting sales goals and delivering timely, accurate, and helpful support. Proficient in managing inquiries and resolving issues professionally and courteously. A versatile professional experienced in overseeing organizational operations across multiple departments, adept at optimizing processes, managing performance, and coordinating teams. Motivated and collaborative leader with excellent problem-solving, communication, and interpersonal skills. Demonstrated success in streamlining business processes and providing strategic direction to support organizational objectives. Experienced in project management, data analysis, problem-solving, and process improvement using various software tools such as Microsoft Office. Hardworking and highly motivated professional eager to enhance business performance by leveraging combined knowledge and skills. Operates effectively in both individual and team capacities, adapting quickly to different processes to drive company objectives. Resourceful and results-driven with a passion for growth and efficiency to meet company needs while increasing service value. A seasoned customer service professional prepared to bring experience and a results-driven approach to a new role. Known for fostering team collaboration and consistently delivering reliable outcomes. Recognized for adaptability and proficiency in handling diverse customer needs.
Overview
18
18
years of professional experience
Work History
Supervising Health Services Rep II
Patient Financial Services
08.2023 - Current
- Organizes and oversees the quality review and training for patient financial counseling and pre-bill claim editing functions
- Supervises unit that performs quality control audits and training
- Develops educational training/seminars consisting of strategies, process and work flow improvements to ensure department and system quality metrics are met
- Presents effective trainings and educational seminars to groups of various sizes
- Guides and evaluates the professional performance and professional development of subordinates
- Presents information and responds efficiently to questions from executives, physicians, department heads, clinical staff, clients, vendors and the general public
- Review registration claims editing information systems and ensures data elements are accurately completed
- Meets fiscal year and revenue cycle targets and goals
- Establishes regular audit schedules, develops plan of correction and implements continuous quality improvement training and feedback process across SVMC Health System
- Responsible for initial and on-going Senior HSR training related to; eligibility screening/coverage, new registration procedures, information system training, co-pay collection, increasing patient satisfaction and clean claim editing rules
- Creates and modifies policies and procedures updating training materials as needed based on policy and procedural changes
- Facilitates meetings with staff members whose areas are impacted by changes or additions to financial screening process and procedures to ensure successful implementation and goals
- Coordinates the resolution of registration and billing problems with all members of the Patient Financial Services Division and works to eliminate inefficient processes and streamline the back-end billing function
- Managed approximately 30 incoming calls, emails and faxes from patients a day.
- Contributed to process improvements by sharing feedback from customer interactions with management teams.
- Managed high call volumes while maintaining a professional demeanor and ensuring timely issue resolution.
Senior Office Specialist
O'Connor Hospital
02.2023 - 08.2023
- Offered diverse clerical support to office team members, managed correspondence, answered telephone calls and tracked documentation
- Collaborated with Hospital Supervisor to ensure quality Staffing
- Maintain professional workflow with staff to ensure clear direction on daily assignments
- Make daily changes in Ansos to ensure quality data
- Creates and/or prepares a variety of correspondence, forms, legal documents, reports, articles, technical specifications, memoranda, resolutions, minutes of meetings or hearings from a variety of mediums, where knowledge of format and presentation is necessary
- Collects and compiles a variety of information regarding work activity of unit, technical data, etc., and generates regular statistical reports; may make recommendations to management based on information gathered and reported
- Researches and keeps apprised of legislative changes in area of specialized knowledge and disseminates information to staff
- Prepares work schedules as instructed of regular, floater, temporary, per diem or registry staff; inspects and confirms accuracy of the staffing schedule; completes weekly staffing variance projection forms and schedules staff; accordingly, maintains required registry personnel documentation
- Maintains computer databases for case tracking, retrieval of information, and maintenance of computer files; performs research to complete database as needed
- Reviews documents, records, and forms for accuracy, completeness, and conformance to applicable rules and regulations; communicates problems and advises on corrections to ensure acceptability
- Operates standard office equipment including computers; performs delegated troubleshooting and maintenance; acts as liaison with systems personnel in solving system problems and developing automation of business functions
- As necessary, performs any departmental work assignment performed by lower-level clerical classifications
- Proactively identified areas for improvement within office procedures, leading initiatives to address these issues effectively.
Patient Access Supervisor
El Camino Hospital
08.2021 - 01.2023
- Provides administrative support via on call phone 24 hours, seven days a week
- Applied HIPAA privacy and security regulations while handling patient information
- Verified demographics and insurance information to register patients in computer system
- Organized and maintained records by updating and obtaining both personal and financial information from patients
- Obtained necessary signatures for privacy laws and consent for treatment
- Assembled registration paperwork and placed identification bands on patient
- Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations
- Communicated financial obligations to patients and collected fees at time of service
- Reviewed eligibility responses to assess patient benefit level and prepare estimates
- Registered patients by completing face-to-face interviews to obtain demographic, insurance and medical information
- Utilized screening tool for self-pay patients to determine payer sources, referring to financial counselors if necessary
- Communicated with patients with compassion while keeping medical information private
- Collaborated with multi-disciplinary staff to improve overall patient care and response times
- Implemented quality assurance measures to ensure that patient access processes adhered to hospital policies and industry best practices for optimal service delivery.
- Reduced employee turnover rate by fostering a positive work environment and providing ongoing support for professional development opportunities.
Financial Counselor
El Camino Hospital
02.2020 - 08.2021
- Organized and maintained records by updating and obtaining both personal and financial information from patients
- Obtained necessary signatures for privacy laws and consent for treatment
- Assembled registration paperwork and placed identification bands on patient
- Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations
- Communicated financial obligations to patients and collected fees at time of service
- Reviewed eligibility responses to assess patient benefit level and prepare estimates
- Registered patients by completing face-to-face interviews to obtain demographic, insurance and medical information
- Utilized screening tool for self-pay patients to determine payer sources, referring to financial counselors if necessary
- Communicated with patients with compassion while keeping medical information private
- Collaborated with multi-disciplinary staff to improve overall patient care and response times
- Obtained insurance authorizations
- Assessed client financial situation and explored background through one-on-one interview process.
Patient Service Rep
El Camino Hospital
08.2019 - 02.2020
- Organized and maintained records by updating and obtaining both personal and financial information from patients
- Obtained necessary signatures for privacy laws and consent for treatment
- Assembled registration paperwork and placed identification bands on patient
- Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations
- Communicated financial obligations to patients and collected fees at time of service
- Reviewed eligibility responses to assess patient benefit level and prepare estimates
- Registered patients by completing face-to-face interviews to obtain demographic, insurance and medical information
- Utilized screening tool for self-pay patients to determine payer sources, referring to financial counselors if necessary
- Communicated with patients with compassion while keeping medical information private
- Collaborated with multi-disciplinary staff to improve overall patient care and response times
- Verified insurance eligibility and coverage for patients.
Admitting Supervisor
Doctors Medical Center
10.2017 - 08.2019
- Assist in managing multiple departments including but not limited to Outpatient, Labor & Delivery, Emergency room, Preadmissions and Credit & Collections
- Round on patients and staff to improve overall satisfaction
- Manage attendance & vacation requests
- On Call for 7 days per month including nights and weekends
- Run daily reports to manage financial reimbursements
- Coordinate meetings and implement new procedures
- Checked patient information and insurance coverage
- Coordinated patient paperwork and charts
- Determined charges and collected co-pays
- Verified schedules and arrival times
- Completed registrations for laboratory work, surgical procedures, and radiology
- Applied knowledge of medical terminology and insurance processes to support office administration productivity
- Delegated work to staff, setting priorities and goals
- Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs
- Analyzed financial activities of department to share budgetary input with managers
- Discussed job performance problems with employees, identifying causes and issues to find solutions
- Computed balances, totals, or commissions to support accounting team
- Recommended solutions related to staffing issues and proposed procedural changes to managers
- Participated in subordinates' tasks to facilitate productivity or help overcome difficulties
- Issued work schedules, duty assignments and deadlines for office or administrative staff
- Recruited, interviewed, and selected employees to fill vacant roles
- Interpreted and explained work procedures and policies to brief staff
- Consulted with managers to resolve problems relating to employee performance, office equipment and work schedules
- Resolved customer complaints or answered customers' questions
- Guided employees in handling difficult or complex problems
- Reviewed reports on employee attendance, productivity, and effectiveness to evaluate performance
- Implemented departmental policies and standards in conjunction with management to streamline internal processes
- Trained employees on best practices and protocols while managing teams to maintain optimal productivity
- Coordinated closely with other hospital departments to streamline interdepartmental communications and enhance patient care continuity.
Administrative Support
El Camino Hospital
07.2009 - 09.2017
- Kept office equipment functional and supplies well-stocked to promote efficient operations
- Pleasantly welcomed visitors, answered phone calls and maintained front reception desk
- Organized files, developed spreadsheets, faxed reports, and scanned documents, maintaining front desk and reception area in neat and organized fashion
- Handled incoming calls and directed callers to appropriate department or employee
- Sorted and distributed incoming faxes, letters, and emails for office distribution
- Assisted with Nursing assignments
Office Assistant
O'connor Hospital
12.2014 - 07.2015
- Greeted visitors or callers to handle questions or direct to appropriate staff
- Organized files, developed spreadsheets, faxed reports, and scanned documents to bolster organizational workflow
- Collected payments, issued receipts, and updated accounts to reflect new balances
- Offered diverse clerical support to office team members, managed correspondence, answered telephone calls and tracked documentation
- Conducted office inventory checks and requested restock of supplies
- Proofread and corrected correspondence and reports for error-free documentation
- Resolved office equipment issues and scheduled service for advanced problems
- Supported bookkeeping through financial transaction documentation, expense reporting and budget monitoring
- Updated electronic and hard copy files, maintaining compliance with company data security and archival procedures
- Monitored calendars and scheduled appointments based on availability and established load limits
- Prepared and made daily deposits and assisted with invoice processing and bank reconciliation
Patient Registrar
O'connor Hospital
08.2011 - 12.2014
- Greeted visitors and established purpose of visit to complete check-in procedure quickly
- Collected and processed copayments and out-of-pocket liability
- Liaised with clinical staff to process and direct patients to appropriate departments
- Screened patients before and during admissions processes
- Communicated with patients with compassion while keeping medical information private
Account Representative II
Palo Alto Medical Foundation
12.2008 - 06.2009
- Maintained good rapport with patients and internal departments by proactively handling complex issues
- Received and processed patient payments and updated accounts
- Set up and updated demographics and insurance on accounts with interactions, collected payments and personal information
- Replenished and arranged items to maintain appearance
- Supported customer satisfaction through regular follow-up and communication.
Registration Specialist
Palo Alto Medical Foundation
01.2008 - 12.2008
- Registered new patients which included insurance coverage and financial status appropriate to established time frames
- Updated all demographics and verified and updated current information on patient's account
- Created and maintained various filing systems in an accurate and organized manner
- Reviewed, purged, and forwarded files to scanning and medical records as appropriate
- Researched and resolved Ecommerce and Pcs denials
- Assisted in training new Registration Specialists, sharing best practices and helping them become proficient in their roles.
- Managed high-volume workloads while consistently meeting deadlines for processing registrations and updating records.
Patient Service Representative
Palo Alto Medical Foundation
12.2006 - 12.2007
- Managed patient reception to ensure each patient was attended to then directed to appropriate location
- Monitored patient appointment schedules which included confirms, cancels, and reschedules
- Assisted in creating patient accounts, chart assignments and prepared charts for the following day Appointments
- Verified current information on patient's account and collected updated patient information at each interaction
- Collected patient payments through computerized cashiering module, in addition to accurately reconciling at the end of each day
- Managed all telephone messages in an efficient and courteous manner while accurately documenting and following up on all telephone messages
- Demonstrated initiative to solve patient complaints to the needs of patients
- Participated in ongoing training programs related to HIPAA compliance, maintaining up-to-date knowledge on regulatory requirements.
Education
Associate of Arts - Health Administration
University of Phoenix
Medical Assistant Certificate -
Center of Employment
High School Diploma -
Abraham Lincoln High School
San Jose, CA06.2003
Skills
- Highly computer literate
- MS Office XP
- OS: XP 2000
- Visio
- Healthcare systems
- IDX
- Patient Care System
- EPIC
- Kronos
- Cerner RCI/Powerchart
- Nextgen
- OnDemand PBAR
- Strong leadership and communication skills
- Strong customer relationship building skills
- Excellent oral and written skills
- Team player
- Strong knowledge of medical terminology
- Thorough understanding of HMO/PPO insurances
- Customer Service
- Training Coordination
- Quality Assurance
- Multitasking
- Organization
- Work Quality Evaluation
- Financial Procedures Adherence
- Scheduling Diagnostic Procedures
- Registration and Admissions
- Problem-Solving
- Insurance Company Knowledgeable
- Service Rates Establishment
- Employee Supervision
- Budget Planning
- Critical Thinking
- Employee Work Scheduling
- Employee Performance Evaluations
- Decision Making
- Process Implementation
- Expenditure Authorization
- Financial Operations Oversight
- Time Management
- Verbal and Written Communication
- Policy and Program Development
- Data Analysis
- Financial Reporting Coordination
- Employee Recruitment and Hiring
- Interdepartmental Functions Coordination
- Clinical and admin staff scheduling
- Strong work ethic
Timeline
Supervising Health Services Rep II
Patient Financial Services
08.2023 - Current
Senior Office Specialist
O'Connor Hospital
02.2023 - 08.2023
Patient Access Supervisor
El Camino Hospital
08.2021 - 01.2023
Financial Counselor
El Camino Hospital
02.2020 - 08.2021
Patient Service Rep
El Camino Hospital
08.2019 - 02.2020
Admitting Supervisor
Doctors Medical Center
10.2017 - 08.2019
Office Assistant
O'connor Hospital
12.2014 - 07.2015
Patient Registrar
O'connor Hospital
08.2011 - 12.2014
Administrative Support
El Camino Hospital
07.2009 - 09.2017
Account Representative II
Palo Alto Medical Foundation
12.2008 - 06.2009
Registration Specialist
Palo Alto Medical Foundation
01.2008 - 12.2008
Patient Service Representative
Palo Alto Medical Foundation
12.2006 - 12.2007
Medical Assistant Certificate -
Center of Employment
Associate of Arts - Health Administration
University of Phoenix
High School Diploma -
Abraham Lincoln High School
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