Rosa Priester
Cocoa,Florida
Summary
Experienced patient account representative skilled in managing administrative tasks related to patient financial responsibilities. Proficient in maintaining accurate patient information and financial data, including diagnoses, treatments, payments, and health insurance coverage. Efficiently processes claims, addresses overdue accounts, and initiates collections when necessary. Adept at obtaining and inputting information into the Florida system while ensuring confidentiality and verifying eligibility based on income and assets. Proficient in gathering data, preparing reports, and maintaining records and files. Provides comprehensive information to patients to ensure their understanding of services and programs. Offers unwavering support to clients by actively listening and providing solace. Experienced in handling the domestic violence hotline for Brevard County and assisting with court orders for injunctions. Conducts thorough intake and discharge interviews while documenting relevant incidents. Approachable professional available to address questions and concerns from advocates.
Overview
20
20
years of professional experience
Work History
Eligibility Supervisor
Elevate PFS
02.2024 - Current
- Mentored new hires and junior staff members, sharing knowledge of best practices in eligibility supervision for their growth and success within the organization.
- Reduced errors in eligibility decisions by regularly reviewing caseloads and providing feedback to staff members.
- Uploaded and submitted verification documents and completed applications.
- Assisted clients in understanding their benefits options by thoroughly explaining program requirements and available resources during consultations.
- Ensured continuity of care for clients transitioning between programs or experiencing changes in their circumstances by updating records promptly and accurately.
- Conducted ongoing training sessions for employees, ensuring up-to-date knowledge on policy changes and best practices in the field of eligibility determination.
- Collaborated closely with other departments within the organization to ensure efficient coordination of services for clients needing additional support or information regarding their cases.
- Improved efficiency of application processing by developing standardized workflows for staff to follow consistently.
- Achieved consistent compliance with federal and state regulations through diligent monitoring of program guidelines.
- Created a positive work environment, fostering open communication and promoting teamwork among frontline workers.
- Evaluated employee performance fairly, providing constructive feedback for improvement while also recognizing exemplary work when appropriate.
- Implemented quality assurance measures for all eligibility decisions, promoting accuracy and consistency across cases reviewed by the team.
- Enhanced client satisfaction with timely and accurate eligibility determinations through efficient case management.
- Maintained detailed documentation on every case evaluated, safeguarding sensitive client information while adhering to confidentiality standards required by law or regulation.
- Facilitated referral to community resources to assist with other needs and intricate issues.
- Developed comprehensive reports on team''s caseload statistics, showcasing trends in decision-making outcomes that informed future process improvements.
- Increased team productivity by establishing clear performance expectations and providing regular coaching to staff members.
- Resolved discrepancies with client applications to verify eligibility.
- Trained staff on current eligibility requirements and policies.
- Built relationships with diverse stakeholders to achieve successful program implementation.
- Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
- Coordinated individual duties after careful evaluation of each employee's skill level and knowledge.
- Completed bi-weekly payroll for Number employees.
- Kept high average of performance evaluations.
Eligibility Team Lead
Meddata/Elevate PFS
01.2020 - 02.2024
- Trained new team members by relaying information on company procedures and safety requirements.
- Promoted a positive work environment by fostering teamwork, open communication, and employee recognition initiatives.
- Served as a role model for the team by demonstrating commitment to excellence, professionalism, and adherence to company values at all times.
- Coached team members in techniques necessary to complete job tasks.
- Managed schedules, accepted time off requests and found coverage for short shifts.
- Conducted regular progress reviews with individual team members to identify areas for improvement and provide guidance on career development opportunities.
Eligibility Advocate
APA LLC
02.2018 - 01.2020
- Worked effectively with fellow team members to coordinate effective solutions to any question or concern.
- Delivered friendly service and offered expert support in every interaction.
- Assisted with applications and collected required paperwork to help individuals register for supportive services.
- Made referrals to appropriate services, following up to confirm patients received access to required care.
- Conducted comprehensive client interviews, gathering relevant information to build a strong case foundation.
- Organized supporting documentation for individuals under evaluation and coordinated paperwork transfers to correct staff members.
- Completed home-visits, reports, scanning, paperwork and documentation accurately and in timely manner.
- Demonstrated strong ethical standards in all aspects of practice, upholding the integrity of the legal profession.
- Conducted pre-screening activities to determine eligibility for supportive services.
- Kept up-to-date on case progress by frequently reviewing records and reporting findings to clients.
Eligibility Representative
Wuesthoff Health System
06.2014 - 02.2018
- Streamlined workflow for faster application processing, resulting in improved turnaround times.
- Managed high-volume caseloads while maintaining strict adherence to privacy regulations and confidentiality protocols.
- Achieved high client satisfaction rates through effective communication and empathetic support during the eligibility process.
- Enhanced client satisfaction by efficiently processing eligibility applications and addressing inquiries.
- Exceeded performance metrics consistently by accurately determining program eligibility within established timeframes.
- Assisted clients with navigating complex eligibility requirements, ensuring accurate submissions.
- Contributed positively to team culture by actively participating in collaborative problem-solving efforts.
- Reduced errors in eligibility determinations through meticulous attention to detail and rigorous quality control measures.
- Balanced responsibilities as an Eligibility Representative with ongoing education pursuits or additional roles within the organization, demonstrating strong time management skills and dedication to continued professional growth.
- Resolved discrepancies with client applications to verify eligibility.
- Processed and certified documents for accuracy and compliance with government regulations.
- Assisted clients with accurate eligibility form, application and document completion.
- Interviewed applicants and explained scope of different available benefits.
- Scheduled appointments with applicants to gather information and explain benefits processes.
Financial Record Coordinator
Wuesthoff Hospice
02.2013 - 05.2014
- Entered data, generated reports, and produced tracking documents.
- Improved team productivity with regular communication and progress updates, fostering a collaborative work environment.
- Enhanced operational workflows by maintaining well-organized documentation systems and updating records accurately as needed.
- Gathered and organized materials to support operations.
- Enhanced customer satisfaction by responding promptly to inquiries and addressing concerns professionally.
- Resolved issues through active listening and open-ended questioning, escalating major problems to manager.
- Oversaw appointment scheduling and itinerary coordination for both clients and personnel.
Medicaid/Workman Compensation Rep
Wuesthoff Hospital
04.2004 - 02.2013
- Handled customer complaints quickly and professionally to restore customer confidence and prevent loss of business.
- Enhanced company reputation by providing exceptional customer service and support.
- Developed and maintained positive customer relations and coordinated with team members to properly handle requests and questions.
- Exceeded performance targets through diligent work ethic and focus on results-driven tasks.
- Learned and followed all organizational policies and procedures to maintain safe and professional working environments.
- Responded to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility, and claims.
- Evaluated customer needs and feedback to drive product and service improvements.
- Helped meet changing demands by recommending improvements to business systems or procedures.
Education
Secretarial and Word Processing -
Business Training Institute
Alabama State University
01.1983
High School Diploma -
Cocoa High School
01.1981
Skills
- Excellent oral, written, interpersonal communication skills
- Detail-oriented, organized, proven ability to work independently; equally effective team player Assess, determine and process eligibility of clients in a timely manner
- Access and utilize community resources and case management
- Maintains cooperative working relationships; demonstrates sensitivity to, and respect for, a diverse population; maintains client confidentiality
Communityvolunteerism
- Licensed Minister who provides support and education to women in crisis through counseling sessions.
- Aspire formally known as Center for Drug Free Living.
- Former volunteer for Wuesthoff Hospice.
Professional Statement
Solid leader with diverse experience in strategic growth of programs in the public health sector, change management skills, and professional ministry to support the underserved. Proven track record of success in being a catalyst for change and a driver of results to improve processes and operations. Personal mission to support efforts social justice initiatives within the community.
Timeline
Eligibility Supervisor
Elevate PFS
02.2024 - Current
Eligibility Team Lead
Meddata/Elevate PFS
01.2020 - 02.2024
Eligibility Advocate
APA LLC
02.2018 - 01.2020
Eligibility Representative
Wuesthoff Health System
06.2014 - 02.2018
Financial Record Coordinator
Wuesthoff Hospice
02.2013 - 05.2014
Medicaid/Workman Compensation Rep
Wuesthoff Hospital
04.2004 - 02.2013
Secretarial and Word Processing -
Business Training Institute
Alabama State University
High School Diploma -
Cocoa High School
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