Nahom Tsegaye
10+ Years Healthcare Administration Expert: Patient Registration, Scheduling, Verification & Authorizations
Los Angeles,CA
Summary
Highly experienced professional with 10+ years of expertise in patient registration, appointment scheduling, insurance verification, billing and prior authorizations. Proven ability to streamline administrative processes and ensure accurate patient information management.
Overview
9
9
years of professional experience
Work History
Patient Service Specialist
Saint Joseph Medical Center
Burbank, California
12.2024 - Current
- Screened patients for eligibility for state, local and federal assistance programs.
- Accessed patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA.
- Maintained knowledge of current insurance requirements for billing purposes.
- Reviewed eligibility responses to assess patient benefit level and prepare estimates.
- Evaluated policies and procedures related to Insurance Verification activities.
- Responded to customer inquiries and complaints, providing timely and effective solutions to maintain high service standards.
- Registered patients by completing face-to-face interviews to obtain demographic, insurance, and medical information.
Human Resources and Patient Care Coordinator
Bright Source Hospice
Beverly Hills, California
03.2021 - Current
- Developed and implemented new employee onboarding.
- Maintained confidential personnel files in accordance with applicable laws and regulations.
- Assisted with recruitment initiatives by interviewing and talent sourcing.
- Monitored office supplies inventory.
- Prepared and submitted electronic prior authorizations and paper claims to insurance companies for payment.
- Performed insurance verification and pre-certification.
- Proficient in ICD-10-CM and CPT coding systems.
- performed data entry functions, and coded data into electronic health record (EHR) systems.
- Researched third party payer guidelines related to prior authorizations, coding and billing processes.
Patient Access Representative
UCLA Medical Center
Westwood, California
05.2021 - 11.2021
- Collaborated with physicians, hospitals, long-term care facilities, social services agencies, insurance companies, home health agencies, and other healthcare professionals to coordinate quality patient care services.
- Assisted in training new staff members on insurance verification processes.
- Worked closely with healthcare providers to resolve any discrepancies regarding patient demographics or insurance information prior to admission.
- Identified potential risks or delays in patient care and worked collaboratively with other healthcare professionals to minimize them.
- Organized paperwork related to admissions, discharges, transfers, laboratory results.
Patient Access Representative
Providence Saint John's Health Center
Santa Monica, California
03.2016 - 03.2021
- Processed patient admissions, registrations, transfers, and discharges according to established procedures.
- Informed patients about payment options, billing policies, and procedures related to their visit or procedure.
- Verified insurance information, collected payments, and scheduled appointments.
- Adhered to HIPAA regulations when handling confidential patient information.
- Reviewed daily reports for accuracy and completeness of data entry.
- Performed bookkeeping duties, preparing and sending financial statements or bills.
Education
Bachelor of Science - Electrical Engineering
Hawassa University
Hawassa, Ethiopia 06-2012
Skills
- Multitasking and Organization
- Scheduling Diagnostic Procedures
- Post-Discharge Care Coordination
- Insurance Verification, Billing and Prior Authorizations
- Emergency Room Registration and Admissions
- HIPAA Compliance
- Team Collaboration
- HR policies and procedures expertise
- Onboarding and Orientations
- Staff Recruitment and hiring
- Proficient ICD and CPT codes
- Data analysis
- Medical services administration
- Strategic planning
- Medical records management
Contact
Los Angeles, CA 90068
Education and Training
Hawassa, Ethiopia
Timeline
Patient Service Specialist
Saint Joseph Medical Center
12.2024 - Current
Patient Access Representative
UCLA Medical Center
05.2021 - 11.2021
Human Resources and Patient Care Coordinator
Bright Source Hospice
03.2021 - Current
Patient Access Representative
Providence Saint John's Health Center
03.2016 - 03.2021
Bachelor of Science - Electrical Engineering
Hawassa University