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Patient Access Case Management

Location:
Queens, NY
Posted:
April 28, 2024

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Resume:

JANICE INIGO

ad5bum@r.postjobfree.com 646-***-**** Ridgewood, NY 11385

Summary

Knowledgeable patient representative offers demonstrated skills in case management and service coordination. Expertly handles complaints, inquiries and service questions to meet patients' access needs and correct problems related to care. Well-versed in policies, procedures and standards.

Skills

Insurance knowledgeable

Payment processing

Epic EMR

Appointment scheduling

Friendly, positive attitude

Kronos Payroll

Experience

Hospital for Special Surgery, Main Campus New York, NY

Patient Access Representative

04/2021 - Current

Verified demographics and insurance information to register patients in computer system.

Applied HIPAA privacy and security regulations while handling patient information.

Organized and maintained records by updating and obtaining both personal and financial information from patients.

Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations.

Obtain patient responsibility estimate when patient is self-pay or insurance is out on network for surgery.

Communicated financial obligations to patients and collected fees at time of service.

Responded to patient concerns and inquiries professionally and efficiently.

Called insurance companies and verified patient coverage.

Addressed patients' complaints-head on, investigated concerns and worked with management to devise solutions.

Call to obtain pre-authorization for recommended service and procedures.

Inform relevant clinicals staff about denials.

Hospital for Special Surgery, Main Campus New York, NY

Patient Access Supervisor

06/2012 - 01/2016

Created and maintained facility documents and records, maintaining accuracy while managing sensitive data.

Led and motivated 20 employees through supervision, training and coaching on duties and daily operational activities.

Resolved conflicts promptly among physicians, nurses and other healthcare employees to keep workflows on task.

Facilitated peer-to-peer conflict resolution.

Initiated training and education programs for supporting healthcare staff.

Processed payroll for 30 employees.

Handle disciplinary action with Human resource and the employees.

Hospital for Special Surgery, Main Campus New York, NY

Senior Registrar

05/2008 - 06/2012

Answered questions and fulfilled requests with friendly and knowledgeable service.

Offered front-facing, enthusiastic approach to customer service, resolving complaints and directing pressing matters to supervisor or most-appropriate party.

Provided hands-on training and coaching for junior staff on office policies and regulations.

Supported development and implementation of clear and successful policies, budgets and procedures for smooth and efficient operations.

Ordered and restocked supplies in line with budget limits and office needs.

Adhered to established policies and operating procedures to verify and update insurance credentials and other client data.

Hospital for Special Surgery, Main Campus New York, NY

Patient Registrar/Appointment Desk

04/2005 - 05/2008

Greeted visitors and established purpose of visit to complete check-in procedure quickly.

Verified and entered necessary information into EPIC.

Set and managed patient appointment schedules using EPIC

Liaised with nurses and other clinical staff to process and direct patients to appropriate departments.

Verified insurance and collected critical data elements to properly identify and bill patients.

Created and maintained accurate and confidential patient files according to regulatory mandates.

Maintained office supplies inventory by checking stock and ordering new supplies.

Adhered to HIPAA requirements to safeguard patient confidentiality.

Called patients to schedule appointments, consistently double-checking information and availability.

Communicated with patients to gather intake data and verify chart information.

Helped patients’ complete paperwork and explained processes and procedures.

Answered 30 average daily phone calls to schedule appointments and address patient inquiries.

Managed incoming telephone calls, including taking messages and directing callers to personnel.

Obtained necessary signatures for privacy laws and consent for treatment.

Interviewed patients upon entrance to hospital, gathered appropriate information and entered data into electronic system.

Education and Training

University of Phoenix Tempe, AZ

Associate of Science in Psychology

09/2010

Languages

Spanish:

Limited



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