Summary
Overview
Work History
Education
Skills
Roles And Responsibilities
Personal Information
Timeline
Generic

Rafael Sanchez

Charleston,SC

Summary

Detail oriented professional with over 12 years of clinical administration experience for MUSC Health in Hospital Patient Accounting as a Department Support Specialist and a Hospital Customer Representative on the MUSC Charleston Campus as part of Optum / Change Healthcare.

Overview

18
18
years of professional experience

Work History

HCR - Hospital Customer Representative

Optum
03.2022 - Current

My Hospital Customer Representative position interacts directly with MUSC self-pay patients or insured patients with specific diagnosis. I see them in their rooms and screen them asking financial and medical questions, I take this information and use Epic to go over their medical records, diagnosis, labs, imaging, pending exams to determine if the patient would qualify for Medicaid or Disability services.


If they qualify then I would fill out an application for them and have them sign it and send the application to the required agency. My communication with MUSC case workers / managers / social workers is directly related to information about a patient and their diagnosis, or a future procedure, which I verify In Epic to determine if assistance is required or possible. I also perform follow ups on the status of patient's applications and make the necessary adjustments if the patient is re-admitted, or their condition has worsened.


The number of patients I see face to face daily range from 5 to 10 along with additional out-patients who I reach on the phone. In addition to my Hospital Customer Representative duties I still perform a lot of the Department Support Specialist duties, which are now incorporated in my current position as Hospital Customer Representative because the Department Support Specialist position was eliminated.

DSS - Department Support Specialist

Optum
03.2012 - 03.2022

My Department Support Specialist duties are primarily office administration, I handled completing Medicaid and Disability applications for the13 HCR's on the team at MUSC and sent the applications to the required agencies with the appropriate medical records I would pull from EPIC.


I did this for the MUSC Midlands hospitals as well. I also managed supply ordering for all MUSC hospitals and kept communication with MUSC Case workers and case managers from Shawn Jenkins Children's Hospital, Rutlege Tower Hospital, Ashley River Tower Hospital, Psych Hospital and Main Hospital. I also communicated with the financial counselors on the same locations and with the social workers for the outpatient clinics in Hollings Cancer Center and relayed information to the assigned HCR or management.


I also did patient screening over the phone for Spanish speaking language patients and went into patient's rooms to collect signatures for applications as needed.

Operations Assistant Head Of Internet Technology

OBCO CHEMICALS
04.2006 - 04.2012
  • Responsible for graphic design including product labels, information flyers and company logo viewable at https://www.obcochemical.com/
  • Setup inventory tracking to ensure accurate information for sales team
  • Enter daily orders for Spanish speaking customers and office staff.

Education

Associate in Applied Science (A.A.S.) In Computer Science -

University of Maryland
04.2005

Strayer College
04.1996

Skills

  • Proficient in Microsoft Office, Word, Excel, Power Point, Outlook, Publisher
  • EPIC Hospital Software
  • Reading medical records, charts labs and imaging
  • Computer/Software troubleshooting
  • Multitasking
  • Managing several patient accounts

Roles And Responsibilities

  • Pulling referrals from EPIC and assigning them to the HCR's using PACE
  • Processing high volumes of applications completed by HCR's by entering, scanning and mailing all the applications to their corresponding agencies
  • Properly screen patient by pulling Medical records and carefully reading diagnosis
  • Screening patients and ask financial and medical questions to determine eligibility
  • Working with case workers located at MUSC fulfilling requests and reaching out to patients
  • Managing the office by making sure all supplies were ordered in a timely manner, also managed all incoming and outgoing correspondence for not only the Charleston team but the remote teams as well
  • Creating confidential information reports required by management on a weekly basis
  • Seeing patients with a self-pay status and screening them to see if they qualify for benefits based on both their financial status and their medical condition which is determined by analyzing the patient's medical records
  • Completing paperwork for patients who qualify for benefits and mailing it to the required agencies
  • Contacting outpatients over the phone and screening them for benefits, sending them the application via FedEx if they qualify
  • Answering and following up on all patient inquiries after the application is completed
  • Website management by creating, updating, and uploading information
  • Responsible for graphic design including product labels, information flyers, and company logo

Personal Information

Date of Birth: 10/24/1975

Timeline

HCR - Hospital Customer Representative

Optum
03.2022 - Current

DSS - Department Support Specialist

Optum
03.2012 - 03.2022

Operations Assistant Head Of Internet Technology

OBCO CHEMICALS
04.2006 - 04.2012

Associate in Applied Science (A.A.S.) In Computer Science -

University of Maryland

Strayer College
Rafael Sanchez