Rachel Lux
Winston Salem,NC
Summary
Healthcare professional prepared to excel in patient care and administrative duties. Proven ability to manage patient interactions, coordinate appointments, and support clinical operations. Known for team collaboration and adaptability, leveraging communication and organizational skills to achieve optimal patient outcomes.
Overview
31
31
years of professional experience
Work History
Patient Service Specialist
Novant Health Urology
10.2024 - Current
- Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.
- Applied HIPAA privacy and security regulations while handling patient information.
- Verified documentation methodically to avoid critical errors impacting care delivery and payments for services.
- Processed patient co-pays, deductibles, and other payments, ensuring accurate financial records.
- Coordinated with clinical staff to manage patient flow, reducing wait times and improving satisfaction.
- Processed payments from patients, including cash, check, or credit card transactions.
- Reported liabilities and risk management concerns to supervisor for review.
- Screened patients for eligibility for state, local and federal assistance programs.
- Verified demographics and insurance information to register patients in computer system.
- Contributed to team meetings, sharing insights and strategies for improving patient access services.
- Obtained necessary signatures for privacy laws and consent for treatment.
- Identified trends in denials or rejections of claims and worked to resolve them quickly.
- Explained various admission forms and policies, acquiring signatures for consent.
- Managed patient check-in process, ensuring accurate data entry of personal and insurance information.
- Monitored waiting areas to ensure a comfortable and safe environment for patients and visitors.
- Reviewed eligibility responses to assess patient benefit level and prepare estimates.
- Verified patients' insurance and payment methods during admissions or check-in processes.
- Scheduled appointments and managed patient records using electronic health record software.
- Collaborated with clinical and administrative staff to meet patient needs.
- Provided assistance with completing paperwork, such as insurance forms and medical history.
- Assisted in the implementation of new technologies and processes to improve patient access services.
- Received patient inquiries or complaints and directed to appropriate medical staff members.
- Prepared daily deposits for processing and reconciled accounts receivable.
Surgical Scheduling Coordinator
Novant Health Medical Group Brain and Spine
03.2023 - 10.2024
- Responsible for processing providers surgical order requests in an efficient and effective manner
- Ensure coordination between providers, patients, and facility on allotted days
- Maximize the surgical hours of providers and Operation Room according to procedure time
- Obtain Authorization from insurance company prior to procedure dates
- Upload all information to the communications and claims tabs in case referral
- Educate patients and provide written medication instructions for hold times
- Coordinate availability with outside vendors and medical device representatives for surgical dates
- Respond to all team messages and in basket tabs of EPIC
- Block and release of providers Operating Room schedule as necessary
- Meet in person with patients on clinical days to set surgical dates
- Advocate for patients in need of financial assistance by connecting them with financial services
Surgical Scheduling Coordinator
Urology Specialist of the Carolinas
08.2022 - 03.2023
- Process surgical orders through EPIC request from providers
- Responsible for obtaining authorizations from insurance carriers
- Corresponding with hospital centralized scheduling team for OR hours
- Coordinate providers schedules for surgery according to procedures
- Obtain all labs, imaging and clinical notes needed prior to consultation
- Educate patients on pre-surgical and post operative appointments
- Process referral request from providers and follow up to ensure completed
- Auditing fee schedule sheets to ensure registration obtained for billing
- Ensuring patients signatures and disclosures of all consents completed prior to procedure
Patient Access Liaison
Garnet Health Medical Center
01.2020 - 08.2022
- Log into and maintain communication device (Vocera) Daily
- Arrive all ambulance for daily assigned zone and verify and band patient
- Verify all demographic information on patient to determine if New or Existing to facility
- Obtaining Insurance Authorization through online applications and phone
- Scan all identification and insurance cards in the system correctly
- Verify all insurance pertaining to encounter are active and remove all inactive
- Obtain patient or assigned Health Care Proxy signature for consent for treatment
- Ensure all Medicare documents are acknowledged and signed when applicable
- Maintain and distribute all folder books for patients from daily zone who are admitted
- Review work ques on dashboard daily and resolve all capable issues for resubmit
- Respond to all emails from management for escalation
- Determine and obtain all insurance copayments and close cash drawer daily
- Provide appropriate information to patients with workers compensation or No-fault cases
- Monitor assigned Work Que’s for error and follow up
- Cross Train New Hires in Emergency Room and Same Day Surgery Center
- Correspond with insurance companies and providers to ensure Authorization obtained
- Escort patients and visitors to Surgical Center
- Coordinate with Admission Nurse for direct admissions from other facilities
- Process morgue release for medical examiner and funeral directors
- Code Calling through hospital intercom when applicable
- Process applications for patient advocates and ensure all documents received for review
Scheduling Coordinator
Orange Radiology
04.2017 - 05.2019
- Scheduled radiology and diagnostic studies in three facilities
- Verified eligibility for all insurance including No-Fault and Workers Compensation Cases
- Ensured prescription and authorization obtained prior to service date
- Effectively screened patients for medical history prior to appointment setting
- Provided patients with preparation instructions for all diagnostic studies
- Correspond daily with referring providers offices to process STAT request for same day service
- Monitored all facilities electronic request approved by authorizations department
- Coordinated with doctor’s scheduler for all biopsy procedures
- Demonstrated exceptional customer service, upholding all HIPPA laws with discretion and empathy
Front Office Medical Receptionist
Catskill Dermatology
07.2016 - 04.2017
- Registered patients at specialty office
- Verified insurance eligibility and patient responsibility
- Collected copayments and out of pocket upon services rendered
- Scheduled new patients and follow up
- Translated for patient and provider before and after medical exams
- Pulled medical charts for existing patients and creating charts for new patients
- Ensured medical labs and biopsy reports available prior to follow up
- Corresponded with pharmacy for new prescription requests and refills
- Obtained referrals and prior authorizations for treatment and surgical procedures
Front Office Medical Receptionist
Dr. Raymond Hui
03.2016 - 07.2016
- Greeted and checked in patients and collected personal, medical and insurance information
- Verified insurance eligibility and collected self-pay, co-pay
- Scanned of ID cards and processing of credit card transactions
- Scheduled appointments with secondary care providers
- Coordinated physician’s schedules and maintained patient arrivals and cancellations
- Utilized EMR software to manage patient records and files
- Managed office and medical supplies for clerical and clinical needs
- Scheduled vendors for conferences with physician
- Maintained physical charting system, sending and receiving of all correspondence
- Resolved daily reconcile report and ensuring money envelope delivered daily to lockbox
- Experienced in processing Electronic Prescriptions, obtaining labs, radiology reports or results
- Delivered labs and specimens to clinical labs for processing
- Obtained referrals and Prior Authorizations for patients
Business Service Representative/Project Coordinator
TWC Business Class
08.2010 - 06.2015
- Responsibly provided exceptional client services in an Inbound-Outbound call center setting
- Successfully trouble shot and diagnosed client service issues, preventing unnecessary truck rolls
- Coordinated appointments with operations and clients
- Reviewed and resolved all billing discrepancies
- Identified service needs and promoted current services for retention & processing of upgrades
- Followed up to ensure satisfactory resolution with client
- Coordinated large projects for major accounts from point of sale to installation
- Analyzed client service requests such as upgrades and New installations
- Responsibly conducted meetings on a daily, quarterly, and annual basis
- Reviewed and responded to escalations within the established allotted time frame
- Researched and processed activations during assigned days
- Scheduled and verified all information with clients prior to installation of services
- Followed up on orders that are pending site surveys and construction for installations
- Processed complex phone orders with multi lines, RCF’s and porting through LEC’s
Member Service Representative
Blue Cross and Blue Shield (Wellpoint)
01.2008 - 01.2010
- Answered incoming calls regarding membership benefits and services.
- Attended training sessions regularly to stay abreast of changes in company policies or procedures.
- Maintained accurate records of member interactions and transactions.
- Responded promptly to emails from members seeking assistance.
- Helped members resolve account problems and navigate internal systems to handle routine needs.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Leveraged software and systems to research and resolve member inquiries.
Medical Billing Account Representative
Healthcare Systems Inc
01.2006 - 01.2008
- Researched credit card chargebacks and processed refunds accordingly.
- Managed all payments processing, invoicing and collections tasks.
- Conducted regular audits of customer accounts to verify accuracy of billing information.
- Verified accuracy of information and resolved discrepancies with vendors before entering invoices for payment.
- Generated detailed financial reports for management review.
- Monitored changes in industry regulations related to billing practices and ensured compliance with laws and regulations.
- Processed and sent invoices, adjustments, and credit memos to customers.
- Submitted claims to insurance companies.
Operations Coordinator
Verizon Wireless Corporate
01.2001 - 01.2006
- Implemented customer service standards that increased client satisfaction.
- Allocated resources and materials to respective departments to accommodate needs.
- Ensured compliance with organizational policies, regulations, and standards.
- Coordinated daily operations activities and assigned tasks to staff members.
- Managed daily functions of deskside support, including defining and implementing processes.
- Conducted training sessions for new employees on operational procedures.
- Created documentation outlining operating instructions for staff members.
- Assisted with the organization and execution of operational processes.
- Reviewed financial statements and sales or activity reports to measure productivity or goal achievement.
- Managed scheduling and staffing, optimizing labor costs while ensuring operational demands were met.
- Liaised between customers and management to ensure smooth operations delivery.
- Analyzed data to identify areas of improvement within the business.
- Provided technical support for internal software applications.
- Organized meetings, conferences, and other events related to operations.
- Trained, mentored and motivated employees to maximize team productivity.
- Prepared weekly schedules to verify proper floor coverage within fiscal guidelines.
- Generated reports detailing performance metrics and progress against goals.
- Trained new employees on operational protocols, significantly reducing onboarding time.
- Used excellent verbal skills to engage customers in conversation and effectively determine needs and requirements.
- Collaborated with subordinate managers to assess needs and optimize activities.
- Managed communications between departments to ensure efficient operations.
Medical Billing Account Representative
Medi-Tab Consultants Co, Inc
01.1996 - 01.1998
- Managed all payments processing, invoicing and collections tasks.
- Conducted regular audits of customer accounts to verify accuracy of billing information.
- Verified accuracy of information and resolved discrepancies with vendors before entering invoices for payment.
- Generated detailed financial reports for management review.
- Monitored changes in industry regulations related to billing practices and ensured compliance with laws and regulations.
- Processed and sent invoices, adjustments, and credit memos to customers.
- Submitted claims to insurance companies.
- Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
- Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology.
Medical Records Clerk
Healthcare Systems Inc
01.1995 - 01.1996
- Processed and responded to external requests for medical records following established protocols.
- Verified insurance eligibility prior to releasing protected health information.
- Retrieved medical records upon request from healthcare professionals.
- Responded to inquiries from patients, physicians and other healthcare providers regarding medical records.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Organized and filed hard copy patient records in designated areas.
- Safeguarded patient records, managing data transfers in compliance with HIPAA standards and organizational regulations.
- Implemented updates and improvements to electronic health records systems as directed.
- Participated in quality assurance activities to enhance the accuracy and privacy of patient records.
- Managed release of information requests and identified requestors as patient, relation or provider.
- Organized patient charts, gathering medical histories, lab results and consents.
- Tracked and processed release of information requests.
- Answered questions and fulfilled requests with friendly and knowledgeable service.
- Pulled patient records and transferred information to appropriate parties.
- Entered data into electronic health record systems.
Education
B.S. - Healthcare Administration
University of Phoenix
Phoenix, AZ10.2025
High School Diploma - undefined
North Rockland High School
Thiells, NY06.1994
Skills
- Salesforce
- Microsoft Office Suites
- People Soft
- Microsoft
- Kronos
- Safari
- Medical Manager
- Lotus123
- ECW
- Prognosis
- Navinet
- OneSource
- EPIC
- I-Q
- Schedule organization
- Customer engagement and support
- Calendar coordination
- Daily timekeeping
- Confidentiality requirements
- Meeting planning
- Data entry
- Teamwork and collaboration
- Documentation skills
- Administrative support
- Program organization
- Timesheet management
- Process improvement
- Time management skills
- Patient scheduling
- Medical terminology
- Strong work ethic
- Problem-solving
- Referral coordination
- Quality assurance
- Insurance verification
- Medical billing
- Attention to detail
- Patient registration
Accomplishments
- Promoted to Preceptor during Covid-19 Pandemic in Emergency department of Garnet Health Medical Center.
- Received a recognition award during Covid-19 Pandemic at Garnet Health Medical Center for Performance.
- Promoted to Lead Surgery Scheduler at Novant Health Brain and Spine for going above and beyond for patients and providers.
- Promoted to Preceptor in Novant Health Brain and Spine for new hires.
Languages
Spanish
Timeline
Patient Service Specialist
Novant Health Urology
10.2024 - Current
Surgical Scheduling Coordinator
Novant Health Medical Group Brain and Spine
03.2023 - 10.2024
Surgical Scheduling Coordinator
Urology Specialist of the Carolinas
08.2022 - 03.2023
Patient Access Liaison
Garnet Health Medical Center
01.2020 - 08.2022
Scheduling Coordinator
Orange Radiology
04.2017 - 05.2019
Front Office Medical Receptionist
Catskill Dermatology
07.2016 - 04.2017
Front Office Medical Receptionist
Dr. Raymond Hui
03.2016 - 07.2016
Business Service Representative/Project Coordinator
TWC Business Class
08.2010 - 06.2015
Member Service Representative
Blue Cross and Blue Shield (Wellpoint)
01.2008 - 01.2010
Medical Billing Account Representative
Healthcare Systems Inc
01.2006 - 01.2008
Operations Coordinator
Verizon Wireless Corporate
01.2001 - 01.2006
Medical Billing Account Representative
Medi-Tab Consultants Co, Inc
01.1996 - 01.1998
Medical Records Clerk
Healthcare Systems Inc
01.1995 - 01.1996
B.S. - Healthcare Administration
University of Phoenix
High School Diploma - undefined
North Rockland High School