Patient Access Insurance Verification
Resume:
CAROLYN BAPTISTA
** ******** *****, *** ******, New Jersey 732-***-**** *******@*******.***
PROFESSIONAL SUMMARY
Highly organized and resourceful professional with a strong ability to manage multiple priorities efficiently. Proven track record of providing exceptional service, maintaining professionalism, and demonstrating integrity. Adept at scheduling coordination, patient access, insurance verification, and medical coding. Strong problem-solving and communication skills with expertise in healthcare administration, guest relations, and financial management. CORE SKILLS
Healthcare Administration: Patient Access, Insurance Verification, Scheduling & Coordination Medical Billing & Coding: ICD-10, Medicare/Medicaid Compliance, Claims Processing Regulatory Compliance: HIPAA, CMS Guidelines, Medicare Secondary Payer Rules Customer Service & Communication: Patient Relations, Conflict Resolution, High-Volume Call Management Financial Management: Cash Handling, Payment Processing, Reconciliation, Financial Assistance Guidance Technical Proficiency: EPIC, Navinet, Microsoft Office Suite (Word, Excel, Outlook, PowerPoint) PROFESSIONAL EXPERIENCE
Hackensack Meridian Health Patient Access Specialist March 2021 – Present
● Serve as the primary point of contact for patients and visitors, ensuring a seamless check-in and scheduling experience.
● Manage patient registration, insurance verification, pre-certifications, and referrals in compliance with hospital policies.
● Process prior authorizations, verify benefits via EPIC & payer portals (e.g., Navinet), and confirm coverage to ensure timely reimbursement.
● Educate patients on financial responsibilities, process payments, and assist with financial assistance programs.
● Ensure compliance with Medicare Secondary Payer guidelines and obtain required consent forms.
● Handle a high volume of phone inquiries while maintaining excellent customer service.
● Coordinate with case management for insurance notifications and clinical documentation submissions.
● Uphold HIPAA regulations, patient confidentiality, and hospital policies. Circles for Hackensack Meridian Health Supervisor September 2019 – March 2021 (Promoted in October 2020)
● Managed scheduling and operations across two locations, overseeing a team of six employees.
● Conducted inventory checks, ensured stock levels were maintained, and reconciled monthly expenses.
● Led routine staff meetings and training sessions to uphold compliance with new protocols and procedures. Concierge / Guest Relations
● Provided exceptional guest service by fulfilling patient and visitor requests with professionalism and efficiency.
● Managed patient service requests within a centralized database and ensured timely responses. Kindred Healthcare Utilization Specialist & Hospice Medical Coder
● Conducted inpatient medical coding using ICD-10, ensuring compliance with CMS and hospital policies.
● Reviewed and interpreted medical records to assign accurate diagnosis and procedure codes.
● Maintained knowledge of sequencing rules, documentation queries, and regulatory coding guidelines. Hampton Inn Front Desk Supervisor
● Managed guest check-ins, check-outs, room assignments, and billing adjustments.
● Trained new employees and provided support to ensure efficient team operations.
● Processed payments, secured deposits, and reconciled daily financial reports. Raritan Bay Medical Center Health Unit Coordinator
● Transcribed doctors’ orders and medication records, ensuring accurate patient documentation.
● Managed patient admissions, discharges, and coordinated with nursing staff and physicians.
● Processed laboratory orders and maintained patient charts. CoreStates Mortgage Services Bankruptcy Manager
● Managed the bankruptcy portfolio, filed notices, processed payments, and monitored accounts.
● Communicated with attorneys, bankruptcy courts, and trustees to ensure compliance with regulations. Cenlar Federal Savings Bank
Senior Bankruptcy Administrator
● Oversaw a portfolio of 300 bankrupt first mortgage loans, filing Proof of Claims and managing bankruptcy proceedings.
Senior Collection Representative
● Managed a portfolio of 7,500 delinquent mortgage loans, handling collections and loss mitigation procedures.
EDUCATION & CERTIFICATIONS
● Middlesex County College, Edison, New Jersey
● Middlesex County Vocational-Technical School, East Brunswick, New Jersey
● Cedar Ridge High School, Old Bridge, New Jersey
● Board Certified Medical Assistant
● Licensed Home Health Aide
● Certified Medical Coder
● Licensed New Jersey Notary
TECHNICAL SKILLS
● EPIC, Navinet, CPI Bankruptcy Tracking, Lotus, WordPerfect, PACER
● Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)
● Hotel OnQ System
● Typing Speed: 55 WPM
REFERENCES
Available upon request.
Contact this candidate