Paulina Chavez
Sparks,NV
Summary
Detail oriented healthcare professional with over three years of experience supporting revenue cycle operations, clinical documentation review, charge accuracy, and insurance workflows within Epic systems. Skilled in data accuracy, payer communication, and process improvement.
Seeking to contribute analytical and system based expertise within Revenue Integrity while continuing to grow in healthcare systems and analytics.
Overview
3
3
years of professional experience
Work History
Medical Assistant
Renown Health
01.2025 - Current
- Assist healthcare providers with patient examinations and procedures to enhance workflow efficiency.
- Manage patient records using electronic health record (EPIC) to ensure data accuracy and confidentiality.
- Maintain detailed documentation of insurance communications, approvals, and denials to support revenue cycle processes.
- Submit and track prior authorizations with commercial and government payers to ensure compliance with insurance contract requirements.
- Review provider documentation for accuracy and completeness before submission to minimize denials.
- Maintain detailed records of authorization approvals, denials, and payer communications for audit and follow-up purposes.
- Manage multiple patient cases simultaneously while meeting insurance deadlines and documentation requirements.
Medical Front Office Representative
Community Health Alliance
09.2022 - 01.2025
- Verified patient insurance eligibility and benefits with commercial and government payers to ensure accurate billing and reimbursement.
- Verified patient insurance eligibility and benefits through payer portals and direct insurer communication
- Coordinated directly with insurance representatives to clarify coverage policies, contract terms, and reimbursement guidelines.
- Reviewed patient accounts for accuracy, identifying discrepancies in coverage, and payment responsibility.
- HIPAA compliance while handling confidential patient and insurance information.
Education
High School Diploma -
Truckee Meadows Community College
Reno, NV2025
High School Diploma -
North Valleys High School
Reno, NV06.2021
Skills
- Revenue integrity support
- Clinical documentation accuracy
- Data analysis and reporting
- Workflow optimization
Languages
Spanish
Native or Bilingual
Timeline
Medical Assistant
Renown Health
01.2025 - Current
Medical Front Office Representative
Community Health Alliance
09.2022 - 01.2025
High School Diploma -
Truckee Meadows Community College
High School Diploma -
North Valleys High School