Melissa Otero
Tucson
Summary
Motivated and dedicated professional with extensive experience in office administration and patient interaction. Proven ability to manage schedules, maintain records, and verify insurance eligibility efficiently. Committed to continuous learning and personal growth while contributing to team success. Seeking opportunities to leverage skills in a dynamic environment.
Overview
18
18
years of professional experience
Work History
Discharge Planner
Carondelet St. Mary's Hospital
Tucson
01.2025 - Current
- Coordinated post-hospital services including home healthcare and skilled nursing facility placement.
- Ensured compliance with Medicare and insurance regulations for discharge planning.
- Maintained accurate documentation of discharge plans, assessments, and communication with healthcare providers.
- Engaged in continuing education programs to enhance professional knowledge.
- Collaborated with healthcare providers to address barriers to safe patient discharges.
- Documented discharge planning activities in electronic health record systems for continuity of care.
- Assisted in the coordination of services needed after hospitalization such as home health care, durable medical equipment, transportation.
Eligibility Specialist (Remote)
Pima Heart and Vascular
Tucson
07.2019 - 11.2024
- Conducted interviews with benefits recipients to assess eligibility at specified intervals.
- Maintained accurate records of patient interactions and eligibility determinations.
- Interpreted and communicated eligibility requirements, application details, payment methods, and applicants' legal rights.
- Verified information through employer checks and reference inquiries for accuracy.
- Reviewed detailed insurance and benefits documentation to ensure compliance.
- Established collection and payment plans for patient care services.
Patient Access Representative
Oro Valley Hospital
Oro Valley
01.2014 - 07.2019
- Explained policies and procedures to patients using medical and administrative expertise.
- Managed patient check-in process to ensure efficient service delivery.
- Trained new staff on patient access procedures and hospital protocols.
- Collected copays, deductibles, and self-pay deposits for facility services.
- Verified eligibility and authorization for all patients in Emergency Room and Outpatient Surgery.
- Entered accurate demographic and insurance data into hospital computer system.
- Notified insurance companies of all inpatient admissions to ensure coverage.
Billing Poster
Arizona Community Physicians
Tucson
12.2012 - 07.2013
- Downloaded remits and printed daily insurance batches for processing.
- Balanced insurance remits each day to ensure accuracy.
- Collaborated with billing team on patient accounts to resolve discrepancies.
- Coordinated efforts with team members to meet production schedules and deadlines.
- Posted electronic and manual payments from patients and insurance companies, ensuring timely and accurate allocation to patient accounts.
- Maintained strict confidentiality of patient and financial information.
Representative, Technical Assistant
Radiology Ltd
Tucson
06.2007 - 11.2012
- Analyzed patient financial capabilities to establish sliding scale charges.
- Coordinated communication between departments to enhance service delivery.
- Assisted co-workers during busy periods or whenever needed in order to provide excellent customer service.
- Answered phones and scheduled appointments efficiently to maximize office productivity.
- Entered demographic and insurance data into electronic systems accurately.
- Informed patients regarding necessary biopsy or follow-up appointments through direct interaction.
- Recorded mammogram and Dexa scan scores in data management system to ensure accurate tracking.
Education
Unit Clerk Certification - Unit Clerk
Pima Medical Institute
Tucson, AZ11-1997
High School Diploma -
Flowing Wells High School
Tucson, AZ05.1992
Skills
- Discharge planning
- Time management
- Community resource coordination
- Data entry and typing
- Insurance verification
- Records management
- HIPAA compliance
- Hospital operations
- Word processing
- ICD-10 knowledge
- Teamwork and collaboration
Timeline
Discharge Planner
Carondelet St. Mary's Hospital
01.2025 - Current
Eligibility Specialist (Remote)
Pima Heart and Vascular
07.2019 - 11.2024
Patient Access Representative
Oro Valley Hospital
01.2014 - 07.2019
Billing Poster
Arizona Community Physicians
12.2012 - 07.2013
Representative, Technical Assistant
Radiology Ltd
06.2007 - 11.2012
Unit Clerk Certification - Unit Clerk
Pima Medical Institute
High School Diploma -
Flowing Wells High School
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