Sylvia Rubio
Oswego,IL
Summary
Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
26
26
years of professional experience
Work History
WIC Specialist
Kendall County Health Department
12.2023 - Current
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Conducted regular quality assurance checks on interactions with customers to ensure agents were meeting established guidelines and standards for service excellence.
- Handled customer inquiries and suggestions courteously and professionally.
- Answered constant flow of customer calls with minimal wait times.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
RCM Patient Access Specialist
Duly Health And Care
05.2023 - 09.2023
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Collected and validated patient demographics and insurance information.
- Resolved customer complaints using established follow-up procedures.
- Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
- Helped address client complaints through timely corrective actions and appropriate referrals.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Investigated and resolved customer inquiries and complaints quickly.
- Responded to customer requests, offering excellent support and tailored recommendations to address needs.
- Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
- Followed up with customers about resolved issues to maintain high standards of customer service.
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
Financial Assessor Patient Accounting
Northwestern Medicine
02.2019 - 12.2022
- Utilize Government, commercial and regulatory guidelines for collection of outstanding accounts ⦁ Recommend accounts for contractual or administrative write off and provide appropriate justification and documentation
- Upload clinical documents received from outside facilities
- Maintain patient confidentiality per HIPAA regulations
- Provide exceptional customer service to establish a positive first impression
- Run real time eligibility on all patients to verify insurance through RTE
- Proactive in preventing issues with patient visit by double checking demographics and current active insurance
- Ensure there are no duplicate patient records.
- Liaised between patients, insurance companies, and billing office.
- Delivered timely and accurate charge submissions.
- Followed regulatory standards and maintained compliance with information privacy practices.
Auto Claims Customer Service
Liberty Mutual Insurance Company
10.2017 - 02.2019
- Guided customers through complex documentation requirements, simplifying the submission process for them while increasing accuracy in record keeping.
- Conducted thorough research and analysis to accurately assess claim validity, minimizing financial risks for the organization.
- Provided comprehensive explanations of policy coverages, enabling customers to make informed decisions about their claims.
- Maintained accurate records of claim details, facilitating smooth communication between insured and claimant.
- Documented customer interactions and transactions for accurate, up-to-date records.
- Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
- Provided exceptional customer service during emotionally difficult situations for policyholders following accidents
- Established an effective system for tracking and monitoring claims from initial report to final resolution, ensuring timely updates were provided to all relevant parties.
- Streamlined the claims process by effectively coordinating with repair shops and rental car companies.
- Increased overall efficiency in claims handling by utilizing advanced technology tools for documentation, record-keeping, and data analysis.
Patient Account Representative
Advocate Aurora Health
09.2011 - 09.2017
- Claims pended are released and processed within to meet prompt payment requirements
- Notify members and vendors with the appropriate EOB or Humana denial letter when claims cannot be paid
- Process claims while maintaining financial accuracy and procedural accuracy
- Participate in testing and training needed for system upgrades
- Attend department and other training to maintain knowledge of industry standards current and new laws, policies and procedures
- Assists in the managing of collection and self-pay receivables
- Assists in the managing of insurance receivables
- Answer incoming patient calls and/or make outbound calls in an effort to resolve patient balances
- Provide excellent communication and service to resolve patient balances
- Document patient record with actions taken, results of call, and follow up measures required
- Work collaboratively with members and staff across service lines.
Office Administrator
Allstate Insurance
10.1998 - 10.2010
- Quoting and binding new auto and home business according to company guidelines.
- Managing company funds, overseeing the allocation of cash balances making daily deposits.
- Maintained electronic and paper filing systems for easy retrieval of information.
- Coordinated communications, financial processing, registration, recordkeeping, and other administrative functions.
- Tracked office supplies and restocked low items to keep team members on-task and productive.
- Increased customer satisfaction through professional handling of inquiries and prompt resolution of issues.
- Reconciled account files and produced monthly reports.
- Aided in employee onboarding through training new hires on office procedures, software applications, and company policies.
Education
High School Diploma -
East Aurora High School
Aurora, IL05.1998
Skills
- Excellent communication sills
- Strong interpersonal and organizational skills
- Self-motivated
- Effective Time Management
- Regulatory Compliance
- Best Practices Implementation
- Project Management
- Training and mentoring
- Policy Interpretation
Timeline
WIC Specialist
Kendall County Health Department
12.2023 - Current
RCM Patient Access Specialist
Duly Health And Care
05.2023 - 09.2023
Financial Assessor Patient Accounting
Northwestern Medicine
02.2019 - 12.2022
Auto Claims Customer Service
Liberty Mutual Insurance Company
10.2017 - 02.2019
Patient Account Representative
Advocate Aurora Health
09.2011 - 09.2017
Office Administrator
Allstate Insurance
10.1998 - 10.2010
High School Diploma -
East Aurora High School
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