Claudia Alcaras Garcia
Stanton
Summary
Detail-oriented Patient Access Specialist with 10 years of experience in insurance verification, patient registration, prior authorizations, and financial counseling in pediatric and specialty settings. Proven track record in reducing claim denials, ensuring insurance eligibility, and obtaining necessary authorizations while upholding HIPAA compliance. Skilled in training new staff and maintaining operational efficiency in high-volume environments.
Overview
21
21
years of professional experience
Work History
Lead Front Desk Receptionist/Admitting Representative
Rady's Children's Hospital
Orange
10.2025 - Current
- Supervised front desk/hospital admitting operations, ensuring efficient guest check-in and check-out processes.
- Supervised front desk operations to ensure efficient patient check-in.
- Managed multi-line phone system, ensuring timely call direction to appropriate personnel.
- Verified eligibility benefits for Commercial and State funded insurance. Determined Hospital copays and pre- authorization requirement.
- Resolved patient inquiries and concerns promptly, maintaining high satisfaction levels.
- Resolved guest complaints with professionalism, empathy, and a solutions-focused approach, fostering a positive reputation for the hospital.
- Trained new receptionists/admitting representatives in company policies, software usage, and standard operating procedures to ensure consistency in service quality.
- Implemented process improvements, enhancing patient flow and minimizing wait times.
- Coordinated interdepartmental communication, streamlining patient care logistics.
- Provided ongoing mentoring and coaching to junior team members, enabling their skill sets to grow and contribute positively towards successful departmental outcomes.
Financial Coordinator Promoted
Rady's Children's Hospital
ORANGE
04.2025 - Current
- Educated parents/patients on financial responsibilities and payment options, resulting in improved patient satisfaction.
- Reviewed accounts for discrepancies, implementing corrective actions to streamline billing processes.
- Reduced claim denials, ensuring accuracy in insurance verification and pre-authorization processes.
- Maintained strict confidentiality of patient information while adhering to HIPAA regulations throughout all interactions and communications.
- Assisted patients in understanding their benefits and coverage, clarifying complex insurance terms, and providing guidance on out-of-pocket expenses.
- Contacted insurance companies to obtain essential information about policies and payment benefits, facilitating smoother claims processing.
- Checked eligibility and benefits for commercial and state-funded insurance, ensuring accurate billing and reducing discrepancies.
- Handled phone collections for copays and deductibles.
Admitting Representative
Rady's Children's Hospital
Orange
02.2025 - Current
- Assisted patients with registration processes, ensuring understanding and satisfaction throughout.
- Registered patients for lab, surgery, and radiology services in a fast-paced healthcare environment, ensuring timely service delivery.
- Communicated effectively with medical staff to facilitate smooth patient admissions.
- Collaborated with billing departments to verify insurance and secure authorizations, facilitating seamless patient admissions.
- Verified patient information and ensured accurate data entry into electronic health record systems (CERNER).
- Verified patient details in electronic health records to ensure data accuracy. and insurance coverage and collected co-pays.
- Ensured compliance with HIPAA regulations, safeguarding the privacy of sensitive patient information.
- Prioritized workload effectively while handling multiple tasks simultaneously within a fast-paced environment.
Owner of My Own Business
Lola Salon and Spa
10.2020 - 02.2025
- Managed day-to-day business operations.
- Oversaw daily operations, ensuring all tasks were completed accurately and efficiently by team members.
- Oversaw financial management, including budgeting, financial reporting, and tax preparation, ensuring fiscal responsibility.
- Cultivated strong client relationships, leading to increased repeat business and referrals.
- Increased customer satisfaction by implementing efficient business processes and providing exceptional service.
- Consulted with customers to assess needs and propose optimal solutions.
- Coordinated purchasing activities for inventory management., sales, marketing and customer account operations efficiently.
- Negotiated pricing and service terms with customers and vendors, optimizing expenses and enhancing profitability.
Surgery Scheduler/Medical Front Office Receptionist
Gynecologic Oncology Associates
06.2011 - 07.2019
- Arranged pre-operative and post-operative appointments for surgical patients.
- Educated patients on pre-surgery requirements, such as fasting protocols or medication adjustments, resulting in fewer complications on the day of the procedure.
- Verified insurance coverage and obtained pre-authorizations.
- Prioritized and handled urgent requests to ensure timely care for cases requiring immediate attention.
- Answered phone calls and messages for 5-physician multiple medical facilities, scheduling appointments, and handling patient inquiries.
- Ensured confidentiality of sensitive patient information in compliance with HIPAA guidelines and clinic policies.
- Utilized EPIC software to streamline administrative tasks and improve workflow efficiency.
- Performed various administrative tasks by filing, copying and faxing documents.
Medical Assistant/Front Desk Receptionist
James S. Waldman, M.D.
09.2005 - 03.2010
- Obtained and documented patient medical history, vital signs and current complaints at intake.
- Obtained client medical history, medication information, symptoms, and allergies.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Sanitized, restocked, and organized exam rooms and medical equipment to ensure a safe and efficient environment for patient care.
- Assisted physicians with minor surgeries, preparing operating room and sterilizing instruments to support successful procedures.
- Managed medical records by filing, organizing, and scanning documents to maintain accurate and accessible patient information.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
Education
Certificate - Surgical Tech Program
CNI College
Santa Ana, CA09-2010
Certificate - Medical Assistant
Concorde Career College
Garden Grove, CA03-2006
High School Diploma -
Pacifica High School
Garden Grove, CA06-2005
Skills
- Insurance verification
- Pre-authorization processes
- HIPAA compliance
- Documentation
- Data entry
- Scheduling
- Front office management
- Multitasking and organization
- Attention to detail
- Customer relations
- Verbal and written communication
- Telephone etiquette
- Staff management
- Relationship building
- Problem-solving skills
- Typing speed
- Policy enforcement
- Insurance plan verification
Languages
Spanish
Timeline
Lead Front Desk Receptionist/Admitting Representative
Rady's Children's Hospital
10.2025 - Current
Financial Coordinator Promoted
Rady's Children's Hospital
04.2025 - Current
Admitting Representative
Rady's Children's Hospital
02.2025 - Current
Owner of My Own Business
Lola Salon and Spa
10.2020 - 02.2025
Surgery Scheduler/Medical Front Office Receptionist
Gynecologic Oncology Associates
06.2011 - 07.2019
Medical Assistant/Front Desk Receptionist
James S. Waldman, M.D.
09.2005 - 03.2010
Certificate - Surgical Tech Program
CNI College
Certificate - Medical Assistant
Concorde Career College
High School Diploma -
Pacifica High School