Rachel Dorce
Miramar,FL
Summary
Bilingual (English/Creole), responsible and motivated, with excellent written and verbal communication abilities, able to build rapport and facilitate strong, cooperative relationships within an organizational team, although equally productive when working alone, with an uncompromising work ethic. Possessing solid interpersonal skills, with a keen sense of professional propriety and protocol at all times, including thorough respect for policy and procedure.
Overview
13
13
years of professional experience
Work History
Disability Specialist
HCA – PARALLON (TEMP)
03.2025 - 01.2026
- Conduct assessments to determine the support needs of individuals with disabilities
- Advocate for the rights of individuals with disabilities in various settings, including schools, healthcare facilities, and government agencies
- Develop and maintain relationships with community organizations and other service providers to enhance services for individuals with disabilities
- Provide information, referrals, and support individuals with disabilities and their families
- Participate in case management activities, including developing individualized plans and monitoring progress
- Represent individuals with disabilities in fair hearings and other legal proceedings
- Stay current on laws, policies, and best practices related to disability rights and advocacy
- Complete disability application to assist with determination
- Call Social Security to obtain disability final decision
- Obtain medical records EpicCare and Nextech EMR.
Patient Advocate
Oncology Care Partners
12.2023 - 03.2025
- Welcome patients to the practice and perform registration functions
- Accurately record demographic, financial, and other relevant patient information and input into the EMR
- Prepare patient accounts, which may include insurance verification, for the upcoming day to support optimal patient flow in clinic operations
- Confirm patient appointments through electronic means or by placing phone calls to patients and/or caregivers
- Assist with appointment scheduling of new and established patients
- Engage with patients, caregivers, insurance providers, referring providers, and staff over the phone
- Serve as a patient advocate through complying with HIPAA standards when accessing medical records and other important, confidential documentation
- Demonstrate a sense of ownership through contributing to the improvement of the patient’s experience
- Develop and coordinate health care programs
- Developing patient goals and monitoring progress
- Training new staff members and overseeing current staff members to meet facility goals
- Work side by side with social workers to achieve proper care for the patients.
- Verify insurances through insurance portals (availity, Aetna, Oscar, Humana, and etc).
- Pulling records from EPIC
Medicaid Eligibility Specialist
Medix Staffing Agency (Temporary): Broward Health North: Emergency Room
06.2022 - 12.2023
- Screen and evaluate patients for existing insurance coverage, federal and state assistance programs, or hospital charity applications.
- Explain to patients and other entities the eligibility requirements, application process verification requirements for applicable programs.
- Prepare documents; review for accuracy and completeness.
- Maintain and/or create files or record keeping systems. Sort, label file and retrieve documents or other materials.
- Develop and retain a professional relationship with hospital staff.
- Ensure all insurance, demographic and eligibility information is obtained and entered into the system accurately. Document progress notes to the patient’s file and the hospital computer system.
- Follows policies and procedures to contribute to the efficiency of the office. Covers and assists with other office functions as requested.
- Obtain legally relevant medical evidence, physician statements and all other documentation required for eligibility determination.
Patient Services Coordinator
CVSHealth
01.2020 - 06.2022
- Handling incoming calls, process member orders, and track orders while properly documenting member file.
- Handling data entry, back orders and outbound calls as needed.
- Responsible for ensuring superior service for the members and Health Plan partners.
- Responsible for flawless execution of inbound/Outbound calling programs and associated performance metrics.
- Make product recommendations or services to customers based on their needs and preferences.
- Use sales computer technology to maintain customer records and orders.
- Handle customer complaints and provide alternatives and/or solutions to ensure resolution of complaints.
- Reach out to customers via email and telephone to verify account information.
- Ensure customers are satisfied with their purchases or service.
- Keep records of customer interactions, process customer accounts, and file documents.
- Maintain financial accounts by processing customer adjustments
Administrative Assistant
Elite Lab
04.2016 - 01.2020
- In charge of qualifying Medicare patients for at home screenings in regard to hereditary family cancer & adverse drug reactions.
- In charge of scheduling at home-saliva test for Medicare patients.
- In charge of sending out appointment reminder cards to Medicare patients in regard to at home-saliva test
- Process, centrifuge, plate or deliver specimens in a timely manner to the appropriate department for testing.
- Follows and reviews general laboratory, safety, and department policies and procedures.
- Serves as a resource to clients regarding test requirements, specimen submission and other laboratory policies and procedures.
- Obtains demographic information from patients or from the laboratory requisition. Enters accurate information into the appropriate information system. Completes all federal and regulatory forms required for the registration process including obtaining signed consents and financial agreements. Orders laboratory tests directly into the electronic medical record.
- Aliquot, process, label, and store samples for outside reference laboratories.
- Answers telephone calls and assists individual with question and/or concern by following laboratory policies and procedures and consistently uses good telephone etiquette and gives and receives accurate information
Human Resources Specialist
Cirrus Solutions
03.2013 - 03.2016
- Secure necessary authorizations for medical services, procedures, and treatments from insurance providers and relevant entities.
- Review patient records and treatment plans to determine authorization needs and verify insurance coverages.
- Accurately complete and submit authorization forms, ensuring all required information is provided.
- Monitoring pending and denied authorizations, providing additional documentation or appealing decisions as necessary.
- Keep accurate records of all authorizations and related communication to ensure transparency and compliance.
- Keep abreast of changes in regulations, polices, and procedures related to authorizations to ensure compliance.
- Serve as a liaison between patients, healthcare providers, and insurance companies, addressing any issues or delays in the authorization process.
- Using different insurance websites for authorization purposes such as: Oscar, Evicore, Availity, Humana, Blue Cross Blue Shield. Making calls when needed to obtain authorization via phone.
Education
Bachelor of Arts - Global Studies, Psychology
Florida International University
Miami, FL07-2023
Associate of Arts - Social Work
Broward College
Pembroke Pines, FL01.2020
High School Diploma -
High School - Off Campus Learning Center
Hallandale, FL06-2015
Skills
- Ability to work in a team structure
- Complex Problem Solving
- Ability to Plan, Organize and Prioritize Work
- Ability to Analyze Quantitative Data
- Judgment and Decision Making
- Time Management
- Critical Thinking
- Adaptability and ability to work under pressure
- Proficiency with Microsoft Word
- Proficient in Excel
- Proficient in PowerPoint
- Customer Service
Languages
CREOLE
Full Professional
Timeline
Disability Specialist
HCA – PARALLON (TEMP)
03.2025 - 01.2026
Patient Advocate
Oncology Care Partners
12.2023 - 03.2025
Medicaid Eligibility Specialist
Medix Staffing Agency (Temporary): Broward Health North: Emergency Room
06.2022 - 12.2023
Patient Services Coordinator
CVSHealth
01.2020 - 06.2022
Administrative Assistant
Elite Lab
04.2016 - 01.2020
Human Resources Specialist
Cirrus Solutions
03.2013 - 03.2016
Bachelor of Arts - Global Studies, Psychology
Florida International University
Associate of Arts - Social Work
Broward College
High School Diploma -
High School - Off Campus Learning Center
PROFILE
- Well-organized and punctual; with excellent time management skills
- Precise and very detail-oriented, follows direction with great accuracy
- Responsible and dependable; with a strong work ethic
- Handles situations logically and calmly
- Positive, motivated, and productive