Terri Long-Cruz
Bethel,CT
Summary
Experienced Patient Service Representative known for strong customer service and attention to detail. Successfully enhanced workflows and patient interactions, aiming to support seamless billing processes and uphold patient confidentiality.
Dedicated Patient Service Representative with expertise in insurance verification, conflict resolution, and HIPAA compliance. Committed to enhancing patient experiences and optimizing billing processes.
Detail-oriented professional with over 20 years in healthcare. Proven skills in streamlining billing operations and ensuring compliance with regulations. Focused on improving patient satisfaction and operational efficiency through effective communication and problem-solving.
Overview
23
23
years of professional experience
Work History
Patient Service Representative
Nuvance Health
11.2002 - 04.2026
- Assisted patients with inquiries, ensuring timely resolution and high satisfaction levels.
- Facilitated patient scheduling and appointment management using advanced electronic health record systems.
- Participated in ongoing training programs related to HIPAA compliance, maintaining up-to-date knowledge on regulatory requirements.
- Verified insurance eligibility and coverage for patients.
- Handled customer service inquiries in person, via telephone and through email.
- Entered patient demographic and insurance data into electronic medical record system.
- Processed medical records requests efficiently, safeguarding patient privacy while ensuring timely information access for healthcare providers.
- Assisted with insurance verification tasks, ensuring accurate billing and timely reimbursement for services rendered.
- Actively participated in team meetings focused on improving workflows and enhancing overall practice performance.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Supported new Patient Service Representatives'' orientation process by sharing expertise on office procedures.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Verified patient insurance eligibility and entered patient information into system.
- Followed document protocols to safeguard confidentiality of patient records.
- Worked with patients to ascertain issues and make referrals to appropriate specialists.
Medical Biller-Cardiology Dept
Danbury Hospital
11.2002 - 04.2026
- Processed and submitted insurance claims, ensuring compliance with regulations and hospital policies.
- Reviewed patient accounts for accuracy, resolving discrepancies in billing statements.
- Trained new staff on billing software and best practices to enhance departmental efficiency.
- Collaborated with healthcare providers to obtain necessary documentation for claim approvals.
- Analyzed billing data to identify trends, implementing changes to reduce claim denials.
- Led initiatives to streamline billing operations, improving turnaround time for payments.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Enhanced revenue collections for the medical practice with diligent follow-ups on unpaid claims.
- Implemented quality control measures to identify potential errors before submitting claims, reducing rejections significantly.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Maintained compliance with industry regulations by staying updated on changes to medical billing codes and requirements.
- Delivered timely and accurate charge submissions.
- Collaborated with healthcare providers, ensuring accurate documentation for seamless billing operations.
- Supported efficient scheduling practices by verifying patient eligibility and coverage prior to appointments.
- Resolved discrepancies in accounts receivable reports, contributing to improved cash flow management.
- Conducted regular audits of billing records to ensure accuracy and completeness, enhancing overall financial performance for the practice.
- Adhered to established standards to safeguard patients' health information.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Streamlined billing processes by implementing efficient procedures to improve accuracy and reduce errors.
- Reduced instances of denied claims, carefully reviewing and rectifying coding errors before submission.
- Enhanced accuracy of insurance claims with meticulous verification and updating of patient records.
- Enhanced team productivity by organizing regular training on best practices in medical billing and coding.
- Initiated peer review system for billing codes used, which significantly minimized coding discrepancies.
- Maintained up-to-date knowledge of billing software and healthcare regulations, contributing to department's compliance and efficiency.
- Used data entry skills to accurately document and input statements.
Financial Services Representative
Danbury Hospital
11.2002 - 04.2026
- Assisted clients in understanding financial products and services available at Danbury Hospital.
- Provided accurate information regarding billing procedures and insurance claims to patients.
- Collaborated with healthcare staff to streamline patient account management processes.
- Resolved customer inquiries and issues, enhancing overall patient satisfaction with financial services.
- Trained team members on updated policies related to patient financial services.
- Implemented new tracking systems for improved management of outstanding accounts receivable.
- Streamlined billing processes for increased efficiency and accuracy in payment collections.
- Promoted a positive patient experience, addressing concerns and resolving issues related to billing or insurance coverage.
- Demonstrated adaptability by staying current with changes in healthcare policies and regulations affecting patient financial services operations.
- Contributed to team success by sharing knowledge of best practices in medical billing and coding procedures.
- Facilitated smoother billing process, closely collaborating with healthcare providers to ensure accurate charge capture.
- Improved accuracy of patient billing through meticulous verification of insurance coverage and benefits.
- Contributed to policy updates, providing insights on patient financial interactions that led to more patient-centric billing practices.
- Enhanced patient experience by simplifying financial clearance process, ensuring patients were well-informed prior to receiving services.
- Enhanced team productivity by training new staff on patient financial policies and procedures.
- Supported financial stability of healthcare facility by consistently meeting collection targets.
- Supported transition to electronic billing, ensuring seamless changeover that maintained billing accuracy and timeliness.
- Streamlined communication with insurance companies, ensuring timely submission of claims and expedited reimbursements.
- Facilitated staff training sessions on billing procedures, ensuring consistent understanding across the department for optimal performance levels.
- Improved operational efficiency, adopting best practices in patient financial services that were recognized as benchmarks within healthcare facility.
- Initiated process improvements that led to increased productivity, reducing time spent on manual tasks such as data entry or claim reconciliation efforts.
- Researched billing errors and discrepancies to initiate corrective action.
Skills
- Customer service
- Attention to detail
- HIPAA compliance
- Insurance verification
- Insurance verifying
- Patient confidentiality
- Eligibility determination
- Conflict resolution
- Medical billing
- FLUENT IN Portuguese
- Data protection
- Workflow optimization
- Problem-solving
- Multitasking and organization
- Team collaboration
- EMR
- Process improvement
- Policy understanding
Languages
Portuguese
Native or Bilingual
Timeline
Patient Service Representative
Nuvance Health
11.2002 - 04.2026
Medical Biller-Cardiology Dept
Danbury Hospital
11.2002 - 04.2026
Financial Services Representative
Danbury Hospital
11.2002 - 04.2026