Dedicated Consumer Access Representative with over 7 years of experience in healthcare settings. Expertise in delivering exceptional customer service, efficient appointment scheduling, and effective communication. Skilled in quickly mastering new software and technology while fostering strong relationships among staff and clients. Excels in fast-paced, collaborative environments.
Work History
Senior Patient Service Representative
3 Years 9 Months
Providence Community Health Centers | 01.2023 - Current
• Supervisor Collaboration: Collaborated with Medical Front Desk Supervisor to manage daily patient flow, coordinate front-desk coverage, and ensure timely task completion.
• Staff Coaching and Quality Assurance: Assists in the training and onboarding of entry-level PSRs and Health Center Assistants (HCAs). Ensures that the staff strictly follows up-to-date decision guides, organization-identified call metrics, and registration rules.
• Workflow Technical Expertise: Serves as a primary "go-to" technical resource for front-desk software (Epic), troubleshooting scheduling, templates, and complex registration errors.
• Dispute Resolution: Acts as a point of escalation to manage complex patient issues, resolve complaints, and maintain a compassionate, culturally
• Patient Enrollment Enrollment: Registered and checked in patients, verified identity documents, updated demographic details, and processed primary/third-party health insurance coverage to ensure accurate patient record. Collects patient copays and outstanding balances. Manages, documents, and reconciles daily front-desk cash collections in accordance with accounting guidelines.
• Schedule Maintenance: Builds and maintains physician and dental appointment schedules within specific provider guidelines.
• Patient Centered Medical Care (PCMH): Works dynamically as part of the clinical care team to execute goals aligned with PCHC’s coordinated patient-care management plan.
• Outreach and Continuity: Reviews clinic lists to proactively contact "Did Not Keep Appointment" (DNKA) patients to reschedule, and reaches out to individuals due or past due for their 6-month routine visits.
• Provided bilingual translation services for patients and staff, enhancing communication in medical settings.:
Coordinated patient registration, insurance verification, and demographic updates for accurate visit processing.
Scheduled appointments across multiple providers while balancing urgent requests and continuity of care.
Reconciled patient inquiries by phone, in person, and through electronic messaging with clear service guidance.
Consumer Access Representative
4 Years
Adventhealth | 10.2019 - 10.2023
Obtained complete and accurate demographic and financial information from a variety of sources, including patient interviews, physician offices and in-house departments.
Assessed insurance benefits and authorizations to determine patient's financial responsibility.
Performed pre-certification, credit referral, and deposit collection. Documented incomplete admissions and registrations and updated patients' files.
Read insurance benefits and authorizations to determine patient's responsibility.
Streamlined admission processes by implementing a new intake procedure, enhancing document security and saving time for hospital staff.
Patient Access Representative
2 Years 2 Months
Memorial Hermann Hospital | 05.2017 - 07.2019
Checked in patients at the emergency room to facilitate their registration process. into the ER, answering-incoming calls, maintaining logbook to issue Ambulance/visitor badges
Interviewed patients at workstation or at bedside to obtain all account information via HealthQuest, obtaining necessary signatures for medical care via Ez-forms. Collected emergency room copays at the time of registration.
Verified insurance and financial data, ensuring accuracy of clinical information required for patient registration.
Patient Access Representative
2 Years 1 Month
Kingwood Medical Center | 04.2015 - 05.2017
Obtained copies of identification and insurance cards, activated pre-registered patients, registered and assisted patients; scanned documents into ERS department as well as competitor pricing structures and benefits; ensured data entry was accurate including demographic, financial information, guarantor information, insurance verification, and any notes germane to the patient, per each account.
Secured signatures for treatments, medical information release, insurance benefits assignment, and payment processing to facilitate patient care and compliance.
Obtained identification and insurance copies, activated and registered pre-registered patients, scanned documents into ERS, verified insurance, and ensured accurate data entry for demographic and financial information per account.
Assisted in special projects that aligned with organizational goals.
Claims Associate - Initial Loss Reporting (ILR)
1 Year
State Farm | 07.2013 - 07.2014
Served as initial contact for policyholders, claimants, and other insurance carriers, initiating rental reservations and tow assignments to facilitate timely claims processing.
Gathered information using a loss reporting data entry system for routing to the correct claims segment.
Gathered client information and documented loss details while collaborating with team to manage high volume of claims and calls, effectively leveraging State Farm claims systems and technologies.
Temporary Assignment - Claims Associate
1 Year
Allstate | 07.2012 - 07.2013
Reviewed and processed claims/Executed check processing for timely payments, Delivered customer support by addressing inquiries and concerns/Managed inbound and outbound calls to assist customers.
Handled cases to identify opportunities to resolve issues by working with plan documents, carriers, providers, and members.
Managed claim preparation and financial reconciliation while ensuring compliance with investor and insurer guidelines to recover advancements during the default process.
Mentored and supported the development of newer members of the team.
Team Lead/ Supervisor of Total Loss Processors
6 Years 4 Months
JC Penney | 04.2006 - 08.2012
Hired, managed, developed, and trained staff, established, and monitored goals, conducted performance reviews, and administered salaries for staff.
Facilitated resolution of complex day-to-day employee challenges through motivational and analytical strategies.
Established and updated work schedules to align with staff levels and workload demands.
Developed highly efficient administrative team through ongoing coaching and professional development opportunities.
Supported management decisions, while establishing and maintaining effective relationships with medical staff, other health system departments, clinic departments and co-workers to assure patient satisfaction and organizational-wide goals and standards.
Collaborated with management and built effective relationships with medical staff and departments to enhance patient satisfaction and meet organizational goals.
Worked at Town East Mall to assist customers with their shopping needs.
Moved from Warwick, RI for professional growth and development.
Education
Medical Coding & Billing Program - Medical administration
Lincoln Technical Institute | Lincoln, RI | 02-2010
Skills
Patient Registration
Insurance Claims
Patient Financial Management
Medical Terminology
EPIC System
Experian System
Records Management
Policy & Procedure Compliance
Customer Service
Patient Support
Analytical Skills
Detail Oriented
Time Management Skills
Administrative Skills
Microsoft proficiency
Risk Management Skills
Staff Training
Team Management
Leadership Skills
Interpersonal Skills
Communication Skills
Team collaboration
Diplomatic Skills
Strategic Planning
Organizational Skills
Team Management
Experian System
Timeline
Senior Patient Service Representative
Providence Community Health Centers
01.2023 - CurrentRead More
Consumer Access Representative
Adventhealth
10.2019 - 10.2023Read More
Patient Access Representative
Memorial Hermann Hospital
05.2017 - 07.2019Read More
Patient Access Representative
Kingwood Medical Center
04.2015 - 05.2017Read More
Claims Associate - Initial Loss Reporting (ILR)
State Farm
07.2013 - 07.2014Read More
Temporary Assignment - Claims Associate
Allstate
07.2012 - 07.2013Read More
Team Lead/ Supervisor of Total Loss Processors
JC Penney
04.2006 - 08.2012Read More
Lincoln Technical Institute
Medical Coding & Billing Program from Medical administration