Healthcare Customer Access Specialist Resume Summary
Resume:
Ruben Membrila
Tucson, AZ *****
************@*****.***
Professional Summary
Seeking a position in health care with an established organization in which I may utilize my skills and personal life experiences to grow in knowledge with the organization. Work Experience
Patient Access Representative
Tucson Medical Center-Tucson, AZ
November 2022 to Present
Front desk check in and check out, confirm appointments, confirm insurance prior to appointment, answer incoming calls and assist office wherever help is needed.
• Greeted and checked in patients, ensuring accurate collection of demographic and insurance information
• Scheduled patient appointments, coordinating with healthcare providers to optimize scheduling efficiency
• Verified insurance coverage and obtained necessary authorizations for medical procedures, reducing claim denials by XX%
• Educated patients on financial responsibilities, explaining billing processes and payment options
• Resolved patient inquiries and concerns regarding appointments, insurance coverage, and billing discrepancies
• Collaborated with healthcare team to ensure timely delivery of quality care to patients
• Maintained electronic medical records (EMR) system accuracy by updating patient information and documenting interactions
• Assisted in the coordination of referrals to specialists or other healthcare facilities as needed
• Performed pre-registration activities for upcoming surgeries or procedures, ensuring all necessary documentation is complete
• Implemented process improvements that reduced patient wait times by XX% through efficient registration procedures
• Managed high call volumes in a fast-paced environment while maintaining excellent customer service standards
• Coordinated with medical staff to prioritize urgent cases based on severity of condition or physician's instructions
• Conducted financial screenings to determine eligibility for government assistance programs or charity care services
Referral Specialist
Banner University Medical Center-Tucson, AZ
November 2021 to November 2022
• Process referrals from primary care providers and specialist to other specialist within a 72 hour deadline.
• Scheduled or coordinated the scheduling and authorization prior to in office appointment.
• Acted as liaison between patient and the specialty area by navigating the appointment process.
• Collaborated with providers and departments to determine all CPT codes provided needed for authorization before appointment.
Outpatient Diagnostic Insurance Verification
Tucson Medical Center-Tucson, AZ
February 2020 to November 2021
Interact with physicians and or physician’s office staff to secure diagnosis, procedures, obtain authorization and scheduled patients.
· Completed all insurance verification, documented information into system
· Obtain co-pay, co-insurance, out of pocket maximum and deductible for patient and/or guarantor for anticipated services and admission.
· obtain referral using CPT codes provided
Patient Communication Specialist
El Rio Community Health Center
May 2018 to February 2020
· Provided patient to physician communication, physician to physician communication, served as a resource and contact for information and services and utilization of our EMR system to communicate patient care and schedule & register a variety of appointments effectively and efficiently.
· Served as the initial point of contact for the various practices and services that we support; with the knowledge and ability to guide callers to particular clinic/service based on information provided by patient.
Heavy Equipment Operator
Matheson Flight Extenders
March 2017 to January 2018
• Distributed cargo in such a manner that space use is maximized by handling and moving objects • Operating Vehicles, Mechanized devices, and equipment, inspecting equipment and structures, directed ground crews in the loading and unloading of freight Surgery Scheduler
Genesis OB
May 2015 to December 2015
· Answered telephone and directed calls to appropriate staff
· Scheduled and confirmed patient diagnostic appointments, surgeries, or medication consultations.
· Obtain referrals
· Operate office equipment, such as voice mail messaging systems, and use word processing, spread sheet, or other software applications to prepare reports, invoices, financial statements, letters, case histories, or medical records.
· Maintained medical records, technical library, and correspondence files Inbound Customer Service Representative
Genesis OB
October 2014 to May 2015
· Confer with customers by telephone or in person to provide information about products of services, took and entered orders, cancelled accounts, and obtained details of complaints.
· Checked to ensure that appropriate changes were made to resolve customers problems
· Referred unresolved customer grievances to designated departments for further investigation Outbound Telemarketer
American Red Cross
August 2010 to October 2014
· Contact businesses or private individuals by telephone to solicit sales for goods or services, or to request donations for charitable causes.
· Obtain customer information such as name, address, and payment method, and enter orders into computers.
· Obtain names and telephone numbers of potential customers from sources such as telephone directories, magazine reply cards. And lists purchased from other organizations Education
Equivalency
Arizona High School
Pima Community College
Skills
• Word Processing
• Epic
• WRITING SKILLS
• Level one finger print clearance
• GD&T
• Organizational skills
• QuickBooks
• ICD-9
• Order Entry
• Microsoft Excel
• Heavy Equipment Operation
• Windows
• ICD-10
• Microsoft Powerpoint
• Medicare
• Computer literacy
• Patient Care
• Medical coding
• Medical Terminology
• Medical Scheduling
• Insurance Verification
• Analysis skills
• Customer service
• EHR systems
• EMR Systems
• HCPCS
• Computer Skills
• Data Entry
• Time management
• Manufacturing
• Microsoft Outlook
• ICD coding
• Phone etiquette
• HIPAA
• Computer Operation
• Medical terminology
• Telemarketing
• EMR systems
• Clerical experience
• Typing
• ETIQUETTE
Certifications and Licenses
QMHP Certification
CDL A
Hoisting License
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