Paula Rice
Desert Hot Springs,CA
Summary
Dynamic Medical Patient Representative with a proven track record at Eisenhower Medical Center, excelling in customer service and insurance verification. Enhanced patient satisfaction through effective problem-solving and streamlined appointment scheduling. Recognized for fostering teamwork and mentoring staff, contributing to a culture of excellence in healthcare delivery.
Dedicated administrative professional well-versed in communication and team building. Knowledgeable in medical terminology and scheduling. Ready to bring 19 years of relevant work experience to your team.
Overview
19
19
years of professional experience
Work History
Medical Patient Representative
Eisenhower Medical Ctr
07.2014 - 11.2024
- Facilitated patient check-ins, ensuring accurate data entry and efficient appointment scheduling.
- Addressed patient inquiries, providing timely information on services and procedures to enhance satisfaction.
- Coordinated with healthcare teams to streamline communication between patients and medical staff for improved care delivery.
- Managed insurance verification processes, ensuring compliance with policies and minimizing claim rejections.
- Trained new representatives on best practices in patient interactions and system usage to ensure consistency in service standards.
- Mentored junior staff members, fostering professional development and promoting a culture of teamwork and excellence.
- Resolved billing issues, resulting in increased patient trust and financial stability for the clinic.
- Implemented effective problem-solving techniques to resolve diverse patient concerns promptly.
- Observed all facility rules and regulations regarding patient data to promote confidentiality and integrity.
- Increased accessibility to healthcare services by assisting patients in navigating complex systems.
- Provided exceptional customer service to patients, creating a welcoming and supportive environment.
- Assisted patients with insurance claims, facilitating smooth transactions and proper coverage.
- Maintained strict confidentiality of sensitive information in compliance with HIPAA regulations and company policy.
- Verified any changes or data updates to patient records and checked insurance information at each appointment.
- Contributed to a positive workplace culture by actively participating in team meetings and professional development opportunities.
- Verified patient insurance eligibility and entered patient information into system.
- Followed document protocols to safeguard confidentiality of patient records.
- Trained new staff on filing, phone etiquette and other office duties.
- Provided excellent customer service to patients and medical staff.
- Helped address client complaints through timely corrective actions and appropriate referrals.
Medical Auditor
Desert Cancer Care
09.2005 - 06.2014
- Reviewed billing practices for accuracy, reducing discrepancies in claims submissions.
- Mentored junior auditors on best practices and regulatory guidelines in medical auditing.
- Led initiatives to streamline audit processes, resulting in improved turnaround times for reviews.
- Analyzed findings from audits to inform strategic decisions and recommendations for management.
- Fostered collaboration between clinical staff and administrative personnel to align documentation practices with organizational needs.
- Provided support during external audits conducted by governmental agencies or third-party payers, ensuring timely completion and submission of required documentation.
- Prepared detailed reports outlining audit findings; communicated results to stakeholders promptly for prompt resolution of issues identified during audits.
- Conducted comprehensive chart reviews to validate coding accuracy, ensuring proper reimbursement for services rendered.
- Established strong working relationships with physicians and other healthcare professionals to facilitate open communication channels regarding best documentation practices.
- Collaborated with healthcare providers to ensure accurate documentation for improved patient care quality and safety.
- Reduced financial risk by detecting and addressing errors in medical billing and coding practices.
- Enhanced the accuracy of medical billing by thoroughly auditing patient records and identifying discrepancies.
- Prepared working papers, reports and supporting documentation for audit findings.
- Trained new employees on accounting principles and company procedures.
Education
High School Diploma -
Newton Sr High
Newton Ks04-1976
No Degree -
Wichita Business College
Wichita KsSkills
- Customer service
- Privacy and confidentiality
- Scheduling appointments
- Insurance verification
- Medical terminology
- Patient data confidentiality
- Relationships and rapport
- Recordkeeping
- Trained in [software]
- Cross-cultural sensitivity
- Patient data privacy
- Clinical data entry
- Registration process management
- Registration services
- Patient service and assistance
- Problem-solving
- Friendly and outgoing
- Multitasking and organization
- Team collaboration
- Team leadership
- HIPAA compliance
- Money handling
- Patient education
- Electronic health records
- Relationship building
- Phone and email etiquette
- Flexible schedule
- Data entry
- Conflict resolution
- Policy understanding
- Insurance billing
- Payment processing
- Quality assurance
- Eligibility determination
- Information collection
- Intake assessment
- Records maintenance
- Medical billing
- Fee collection
- Referral coordination
- Insurance company billing
- Patient identity verification
- Teamwork
- Time management
- Attention to detail
- Punctual and hardworking
- Problem-solving abilities
- Calm and effective under pressure
Timeline
Medical Patient Representative
Eisenhower Medical Ctr
07.2014 - 11.2024
Medical Auditor
Desert Cancer Care
09.2005 - 06.2014
High School Diploma -
Newton Sr High
No Degree -
Wichita Business College