Service Representative Data Analysis

Experienced healthcare professional with more than fifteen years of various positions focused in supervising, training and administrative capacity

Skills

Technology savvy, proficient in EPIC (Registration/Scheduling), OMNIPRO, and IBM Reflections. Intermediate in Microsoft Word and Excel, various Insurance Websites, and e-mail applications.

Possess the ability to work in a team structure or work independently

Ability to Plan, Organize and Prioritize Work.

Demonstrated understanding of critical factors in risk minimization and fraud detection

Hands-on expertise and educational background in data analysis, research, and reporting, with a background in credit verification, eligibility confirmation, and payment processing.

Excellent interpersonal, oral and written communication skills, relating effectively with financial partners, vendors, insurance companies, and all other professionals

Professional Experience

Clerical Associate III Aug 2023- Present

NYC Health + Hospitals Queens Jamaica, NY

Serve as a liaison between the clinics, patients and insurance companies.

Answer high volume calls from various clinics to verify patients’ insurance and confirm PCP selection

Analyze and verify insurance benefits and educate patients on their out of pocket costs

Complete PCP change by form for walk in patients via phone, fax and or email

Obtain all authorizations and referrals for all inpatients

Accurately register and document patient demographic and insurance information in the epic system

Verify appointments against the Detailed Appointment Report in the scheduling system

Complete discharge and appointment reports from DAR daily

Contact patients from DAR with outside PCP to schedule appointments to update with a PCP affiliated with QHC

Follow up with non par insurance patients listed on the workque

Refer uninsured patients to financial counselors for insurance eligibility or NYC Care screening

Refer accounts requiring escalation to the supervisor in a timely manner

Eligibility Service Representative 1/2022-10/2022

Brighton Health Plan Solutions

Responsible for receiving and resolving caregiver and member inquires

Worked with the Benefits Enrollment team to review and resolve any eligibility and co-pay issues

follow-up on outreach to customers

Maintained and updated all activity trackers within a designated time frame

Participated in activities designed to improve customer satisfaction and business performance

Supported projects and other departments in completing tasks when directed by management

Assisted members/ providers with benefits and eligibility

Epic Trainer 9/2019 - 6/2020

Jamaica Hospital Medical Center Jamaica, NY

Served as primary classroom trainer for multiple applications

Responsible for training all new non-clinical staff on the Epic system (ADT/PRELUDE, and Grand Central)

Maintained physical classroom spaces to make sure they present a professional and friendly environment

Responsible for class materials upkeep; made sure everything is ready and available when end users come to training

Attended meetings as a representative of the training team to develop an understanding of training from the

operational and application standpoint

Tested and validated curriculum and exercises in the training environment prior to their use in class

Provided feedback to Senior PT on improvements and updates to the curriculum based on classroom/ end-user

experience

Provided assigned on-site support during go-lives and system upgrades

Assisted in tracking and reporting end-user training statistics for attendance, competency, and success rates.

Lead Registrar ER/ Epic Trainer 08/2015 – 9/2019

Flushing Hospital Medical Center Flushing, NY

Provided oversight and direction to the employees in the Emergency Room Department in accordance with the

organization's policies and procedures

Supervised and maintained employee work schedules including daily assignments, rotation and paid time off

Responsible for evaluating new & existing employees working in the Emergency Room Department

Conducted departmental training on the Epic system (ADT/PRELUDE) for all new employees

Created departmental training manuals

Assisted as a Super User in Epic system Go-live and upgrades in addition to daily minor registration issues

Followed-up on any outstanding questions/issues that arisen during Epic system upgrade and departmental training.

Performed other duties and responsibilities, as needed

Emergency Room Registrar Nov 2009 – Aug 2015

Flushing Hospital Medical Center Flushing, NY

Interviewed with patients to obtain demographic and billing information for the registration process

Checked insurance eligibility and benefits with payors and initiated the pre-authorization process

Scanned all insurance and identification cards into the imaging system

Communicated with patients regarding their benefits and financial responsibility

Assisted patients in accurately completing various forms such as (HIPAA, Care Everywhere, Limited Power of Attorney, etc.).

Lead Emergency Admitting Rep Feb 2007 – Nov 2009

Baptist Hospital Jacksonville, FL

Greeted and directed patients and families to appropriate nursing units and departments.

Scheduled and registered new and existing patients, updated established records with demographic and financial information, verified insurance using WEBMD, Availity, and HDX

Responsible for training for all evening shift employees on departmental policies and procedures

Trained staff on insurance verification and supervised workflow.

Education

B.S Medical and Health Services Management 2023- Present

American National University Richmond, VA

A.S Health Information Management 2020 - 2023

American National University Richmond, VA

Certificate of Medical Assistant 2001-2002

ALLEN SCHOOL Jamaica, NY

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