John H. Rice
R1 – RCM/SUTTER HEALTH
Rancho Cordova
16
years of professional experience
I have over a decade of communication skills. I am self-motivated, well organized, and I enjoy working with a team. My background in healthcare includes but is not limited to managing a call center, administrative experience, as well as, planning, performing and implementing processes. As a result, I have in-depth knowledge of analytical and research skills. I am able to use data to adjust and improve processes as needed. I also possess superb written and verbal communication skills. I pride myself on working with a spirit of excellence and professionalism. Above all I am eager to learn new things and I am more than willing to go up and beyond to provide the best service possible.
Work History
Patient Access Associate II
4 Years 7 Months- Ensures compliance and exceptional customer service in verify patient coverage, providing financial counseling, establish pre service payment plans
- Supports securing pre and post service authorizations and resolving escalated inquiries related to patient liability risk
- Provides accurate and timely estimates for Sutter shopping consumers to include every service line for all 24 Sutter facilities
- Identify and coordinate benefit plans to secure payment for all level of care
Patient Advocate II
6 Years- See Duties Above
Eligibility Representative II
2 Years- Analyzed monthly eligibility activity reports. Reconciles current member status reported by the various health plans
- Comprehend contractual language stipulated in the health plans contracts as it relates the management of the membership lives for all clients and all health plans
- Assigned and maintained monthly membership lives appropriately to Primary Care Physicians (PCPs) based on health plan eligibility files and or PCP open/closed rosters
- Accurately updated, maintained and retrieved eligibility information within Sutter Physician Services database
Patient Services Representative
1 Year- Office Team Staffing
- Provided exceptional quality service and support in a variety of areas, including, scheduling appointments, preregister patients and create accounts for clinical services
- Verified and or obtained authorization for services
- Created and maintained patient charts and ensure that the patient account is ready for billing
Customer Service Representative
1 Year- Provided world class customer service and built customer satisfaction and loyalty
- Diplomatically responded to client issues for an accurate and timely resolution
- Provided thorough, efficient, and accurate documentation and updates in all required systems
Customer Service Representative
1 Year- MMC Group Staffing
- Resolved inquiries which fell within the general purview of the EHD functionality
- Provided navigation assistance over the telephone and technical support to any caller using the California State Disbursement Unit website
Education
Bachelor of Science - Human Services
Skills
Problem solver
Adherence to guidelines
policies and laws
Analyze and implement rules
Comprehend policies and regulations
Independent decisions
as needed
Organized
Communication and interpersonal skills
Multi-task and prioritize work
Oral and written communication skills
Planning and execution skills
Manage complex issues effectively
Negotiation abilities
Works well in diverse groups
Intermediate skills in Microsoft Word
Excel
Power Point
Outlook
internet research
and social media
Data/Document Management Software- OnBase
ECARE NEXT
Financial/Accounting Software – FACS
Excel
SALESFORCE
State of California specific software programs – CALWIN (California Welfare Information Network) CASDU (California State Disbursement Unit)
Customer Relations Management (CRM) Software – CSI
EPIC (Electronic Privacy Information Center) CSE (Case Management Software)
Timeline
Patient Access Associate II
R1 – RCM/SUTTER HEALTH
01.2022 - CurrentRead More
Patient Advocate II
SUTTER SHARED SERVICES
01.2016 - 01.2022Read More
Eligibility Representative II
SUTTER HEALTH, SUTTER PHYSICIAN SERVICES
01.2014 - 01.2016Read More
Patient Services Representative
SUTTER HEALTH, SUTTER MEDICAL FOUNDATION
01.2013 - 01.2014Read More
Customer Service Representative
NCO FINANCIAL SYSTEMS INC.
01.2012 - 01.2013Read More
Customer Service Representative
XEROX
01.2011 - 01.2012Read More
University of Phoenix
Bachelor of Science from Human Services
Read More