Zayda Martinez
San Ysidro,USA
Summary
Hardworking and detail-oriented Patient Access Representative with 15+ years of experience in healthcare, specializing in patient care and case management. Proven expertise in managing insurance authorizations, maintaining electronic medical records, and ensuring HIPAA compliance. Skilled in building strong patient relationships, and providing exceptional customer service. Experienced in training staff and optimizing referral processes to enhance patient outcomes. Seeking to leverage extensive healthcare knowledge in a remote setting.
Overview
12
12
years of professional experience
Work History
Patient Access Representative
UC San Diego Health
La Jolla, USA
08.2022 - Current
- Greeted and checked in patients in a high-volume emergency room setting, ensuring accurate collection of demographic and insurance information
- Educated patients on financial responsibilities, explaining billing processes, payment options
- Implements excellent verbal and written documentation skills to educate patients about medical procedures, rights and responsibilities
- Maintained electronic medical records (Epic) system accuracy by updating patient information
- Performed pre-registration for upcoming admission orders, ensuring all necessary documentation is complete
- Ensured compliance with HIPAA regulations when handling sensitive patient information
- Coordinated with external organizations involved in patients' care continuum as needed
Case Manager-Women's Health
Family Health Centers of San Diego
San Diego, USA
10.2013 - Current
- HIPAA privacy protocols
- Prioritized referrals according to urgency and adhered to appropriate referral deadlines
- Data entry into electronic medical records
- Managed and obtained insurance authorizations for patient referrals from physicians
- Managed and maintained appointments, following insurance authorization guidelines
- Assisted in updating Lupron medication policy and steps on how to process
- Assisted in enrolling patients to the BCCTP program (Breast and Cervical Cancer Treatment Program)
- Verified documents and associated records to catch and resolve discrepancies
- Reviewed referral details and expectations with providers and patients requesting new referrals when warranted
- Answered questions and resolved concerns raised by both patients and specialists
- Responsible for training newer staff
Referrals Specialist
San Ysidro Health Center
San Diego, USA
10.2019 - 10.2023
- Provided exceptional service on all incoming calls, demonstrating professionalism and expertise.
- Managed customer expectations by clarifying needs and recommending suitable products and services.
- Processed referrals and secured necessary authorizations efficiently.
- Completed insurance verification forms promptly to ensure seamless operations.
Education
Medical Assistant Diplomat
Pima Medical Institute
San Diego, CA09-2009
Skills
- ICD-10 and medical terminology
- Insurance verification
- Microsoft Excel and Epic
- Case management
- Patient care and medical scheduling
- Data entry and records management
- Anatomy knowledge
- HIPAA compliance
- Bilingual communication
Timeline
Patient Access Representative
UC San Diego Health
08.2022 - Current
Referrals Specialist
San Ysidro Health Center
10.2019 - 10.2023
Case Manager-Women's Health
Family Health Centers of San Diego
10.2013 - Current
Medical Assistant Diplomat
Pima Medical Institute
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