Sandra Goring
Worcester,MA
Summary
- Currently working as a Patient Financial Counselor at Umass Memorial Hospital serving the diverse needs of patients through active communication and responsive engagement with healthcare services and policymakers. Skilled at analyzing case files and databases to speed up inquiry response times and guide information through appropriate personnel channels.
- As a bilingual Financial Counselor, we serve the diverse needs of patients through active communication and responsive engagement with healthcare services and policymakers. Skilled at analyzing case files and databases to speed up inquiry response times and guide information through appropriate personnel channels.
- Assists patients with their insurance options and documentation requirements. Well-versed in scheduling and database management functions helping both adult and children with their Medicaid coverage for disability needs and qualifications.
- Excels at identifying client needs and concerns to improve engagement strategies and overall service. Maintains highest standards of ethics, professionalism and regulatory compliance to ease common stressors and de-escalate potential conflicts.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Patient Financial Counselor
UMASS Medical Medical Center
Worcester, MA
08.2006 - Current
- Assist with Medicare and Medicaid eligibility, application and proper documentation.
- Assist patients with adult and pediatric Medicaid disability applications - MADA.
- Interviews and screen appropriate patient population in multiple settings throughout various campus locations, regarding confidential financial and medical information to establish eligibility for various assistance programs.
- Completes Mass Health, Uncompensated Care (HSNO) and other Medical Assistance applications obtaining all verifications for medical assistance and uncompensated care as required by governmental regulations and guidelines.
- Knowledge of MA Medicaid Assister Portal, MMIS, and NEHEN for the transmission, reporting and follow up of Mass Health & Health Connector Applications.
- Coordinates interviews with interpreters, social workers, case managers, social security outreach workers, drug assistance coordinator, care mobile, doctor’s office and community health centers as needed.
- Maintains follows up on standard Mass Health application to ensure retroactive coverage on inpatient admissions and ambulatory services.
- Follows up directly with Mass Health enrollment and MA Medicaid central processing centers.
- Followed document protocols to safeguard confidentiality of patient records
- Worked with patients to ascertain issues and make referrals to appropriate specialists
- Facilitated communication between patients and various departments and staff
- Recommended service improvements to minimize recurring patient issues and complaints
- Helped address client complaints through timely corrective actions and appropriate referrals
- Increased patient confidence in the billing process by providing clear explanations of insurance benefits and coverage limitations.
- Enhanced patient satisfaction by effectively explaining financial options and answering billing inquiries.
- Negotiated payment plans with patients, maintaining a high rate of successful payments.
- Developed strong relationships with insurance providers, facilitating prompt resolution of claim issues and disputes.
- Provided compassionate assistance to financially challenged patients, identifying potential sources of funding or discounts when applicable.
- Reduced hospital bad debt through proactive communication with patients about their financial responsibilities.
- Improved cash flow by proactively monitoring aging accounts receivables and implementing effective collection strategies.
- Leveraged advanced problem-solving skills to address complex cases involving multiple payers or coordination of benefits.
- Assisted in the development of new policies and procedures to improve overall patient financial experience.
- Facilitated timely resolution of outstanding balances by connecting patients with appropriate resources and support.
- Maintained up-to-date knowledge on evolving healthcare regulations, sharing insights with colleagues for continuous improvement.
- Developed customized payment solutions based on individual patient needs, promoting long-term account sustainability.
- Educated patients on available financial assistance programs, guiding them through application processes when needed.
- Educated patients on available financial assistance programs, increasing their access to necessary healthcare services.
- Streamlined communication between financial counseling department and clinical staff, ensuring unified approach to patient care.
- Managed sensitive patient information with utmost discretion, adhering to all HIPAA guidelines.
- Conducted detailed patient financial assessments to identify suitable payment plans, enhancing hospital's revenue cycle.
- Reduced number of uninsured patient visits by guiding them through insurance enrollment processes.
- Actively participated in community outreach programs to educate public on healthcare costs, insurance, and financial assistance options.
Office Operations Management Support / Multilingual Interpreter
UMASS Memorial Medical Center
Worcester, MA
08.2001 - 08.2006
- In charge of day to day operations such as approval of over time and budgeted working hours as well as night supervision of 24 person staff.
- Coordinated and prioritized interpreter services for outpatient appointments, emergency department and inpatient services .
- Participated in training and education of staff on cultural and linguistic aspects of care of patients with (LEP) as well as assisted in training of interpreters.
- Provided interpreter services (English, Portuguese and Spanish) and document translation to patient with Limited English Language Proficiency (LEP) and providers.
- Provided office management support as needed including data entry.
- Utilized active listening skills and cultural sensitivity to convey accurate interpretations.
- Maintained message content, tone, and emotion as closely as possible.
- Provided oral interpretations for clients during special events, successfully maintaining pace with native speakers to deliver real-time comprehension.
- Enhanced communication between clients and non-English speakers by providing accurate translations in real-time conversations.
- Improved patient outcomes in healthcare settings by facilitating clear communication between medical professionals and non-English speaking patients.
- Used knowledge of accepted ethical guidelines to interpret confidential and sensitive information.
- Communicated with clients to understand interpreting needs and provide best service possible.
- Provided cultural input to speakers to help parties who did not speak similar languages communicate with and understand one another.
- Collaborated with other interpreters to cross-check accuracy of interpretations.
Education
Completed 58 hr. course and internship program in Medical Interpreting HIPPA Training: Seminar on Patient Confidentiality -
Umass Memorial Medical Center
Worcester MA03.2001
High School Diploma -
Lakeshore Collegiate Institute
Etobicoke ON Canada07.1994
Diet and Nutrition Certificate - Community Work
Professora Anna De Oliveira Ferraz Technical School
Brazil02.1985
Skills
- Fluent in English / Portuguese and Spanish
- Knowledge of Medicare and Medicaid Eligibility
- Knowledge of Adult and Pediatric Medicaid Disability Process
- Office Microsoft
Certification
UMASS MEMORIAL MEDICAL CENTER, Worcester, MA Certified Application Counselor – Annual Certification 2019
Languages
Portuguese
Native or Bilingual
Spanish
Professional Working
Additional Information
Volunteer Work
- School Board Member at Worcester Seventh Day Adventist School as Home and School Coordinator Liason for the last 8 years
- Amazon Junior Adventure Club Director - volunteer work with elementaryschool-agee children every other Saturdayforn a total of 10 hours per month
- Busy Bee Food Panty - volunteer 4 hours on most Sunday mornings to help with the Portuguese-speaking population at a local food pantry
Timeline
Patient Financial Counselor
UMASS Medical Medical Center
08.2006 - Current
Office Operations Management Support / Multilingual Interpreter
UMASS Memorial Medical Center
08.2001 - 08.2006
Completed 58 hr. course and internship program in Medical Interpreting HIPPA Training: Seminar on Patient Confidentiality -
Umass Memorial Medical Center
High School Diploma -
Lakeshore Collegiate Institute
Diet and Nutrition Certificate - Community Work
Professora Anna De Oliveira Ferraz Technical School
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