Jul 2005－Feb 2015
Kaiser Permanente Hospital
Advises patients and/or family members of health
plan benefits and exclusions and financial obligations; collects and
verifies membership and other insurance eligibility applicable to
services rendered; collects payments, deposits and/or arranges for
payment plans as appropriate to services; processes applications for
medical financial assistance (MFA) and/or other applications as
appropriate; documents interview, payment arrangements, and all other
pertinent information in Health Connect; assists customers with
complaints or inquiries regarding bills and/or charges including, but
not limited to and explanation of charges. Familiar with Surrogate cases (from other Countries) dealing with agencies regarding Collections. Medicare and Medicaid claims processing. Knowledge of Health Connect, Foundations (Mainframe), Search America, Passport (insurance verifier) Tapestry (communication with RN Case Managers). Knowledge of medical terminology. Familiarity with CPT-4 / ICD9. Ability to work with medical charts and fee schedules.
Type 40 wpm. Windows Navigation skills. Knowledge of and skill in customer service, oral
communication, written communication, problem solving, organizational,
interpersonal relations, flexibility, initiative, detail oriented,
quality management, independent judgment, confidentiality, results
orientation, adaptability, team work, and diversity. Skill in word processing and spreadsheet PC applications. Talking to co-workers, customers, outside vendors, and on the telephone. Reading, writing, speaking and understanding English/Spanish. Mathematical ability, attention to detail (e.g. organization, prioritization, proofing), concentration and alertness.
Jul 2001－Feb 2005
Scripps Memorial La Jolla Hospital
Access Representative/ Ancillary provide administrative and clerical support for a group of patients and caregivers. Assists other care team members to assure optimal patient care. Maintains up-to-date medical records or charts on all patients assigned. (Specific Dep.). Schedule patients and register patients in the computer system. Inputs orders for patients on the computer. Verify patient demographics, insurance eligibility and benefit coverage for all patients registered to the facility for inpatient and outpatient activity. Records all required registration comments and documentation entered in the patient accounts in the computer system. Generates registration faces sheets and other documents delivered to appropriate department and other providers. Responsible for account edits and holds for production of a clean claim for billing purposes. Interprets, identifies, communicates, refers to and documents patient financial responsibility for payment of services rendered. Answers internal and external inquiries from patients, providers and other departments. Performs other duties as assigned. Demonstrates ability to perform competencies as outlined in Access Competency Assessment tools. Able to speak, read and follow instructions in English. Prioritizes several tasks and work independently. Orientation to detail and strong customer service skills. Familiarity with health insurance products and regulations. Knowledge of medical terminology. Completion of Bootcamp training. Is able to handle busy Healthcare environment in Emergency/Trauma Room.