Registration, Denial & Appeal, Collections, Insurance Verification

Lorena R Zarate

**** *********** **. *** **** 281-***-****

Spring, Texas 77373 ************@*****.***

Summary of Qualifications

Proven leader with 22 years of progressive experience in Patient Access Services including 7 years in leadership positions

Certified Healthcare Access Manager

Able to analyze data to identify trends and variances for development of process improvement in areas such as:

Registration

Denial & Appeal

Utilization Review

Point-of-service collections

Insurance Verification

Staffing and overtime utilization

Patient satisfaction levels

Able to build rapport with internal and external customers

Education

Graduated from San Benito High School San Benito TX, May 1981

Work History

Patient Account Representative Customer Service / Collector, Patient Access Representative Denial & Appeals and Utilization Review Coordinator and Patient Access Manager, Memorial Hermann Corporate and Southwest Hospital, Houston, Texas, October 1981 – March 2011

Oversee 21 employees in day-to-day operations of admission, pre-registration, insurance verification, collections, and utilization review, and emergency center.

Set and track employee performance, productivity and accuracy goals.

Hire, coach and evaluate staff.

Accomplishments:

Work in partnership with other key departments to increase outpatient patient satisfaction levels from 22nd to 70th percentile from 2010 to present.

Patient Access Manager, Memorial Hermann Hospital Southwest, Houston, January 2000 – February 2007

Oversaw day-to-day operations of multiple areas of the Patient Access Services Insurance department.

Secured in-house accounts for reimbursement from insurance carriers and guarantors.

Assisted patients with billing inquiries.

Developed and implemented review process to secure managed care accounts resulting in increased collections and decreased denials.

Set and tracked performance, productivity and accuracy goals.

Hired, evaluated, coached and counseled staff.

Provided assistance to patients with billing inquiries via telephone and in person while displaying excellent customer service.

Collected patient payments and set up payment plans.

Researched accounts and made referrals to appropriate areas for resolution

Accomplishments:

Increased team monthly upfront collections from $65,000 to $150,000 in fiscal year 2007.

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