Summary
Overview
Work History
Education
Skills
Timeline
Generic

Rachel N. Malvin

Bolingbrook

Summary

A proactive problem-solver with a strong background in quality control, medical coding, patient registration, and financial transactions, consistently achieving maximum productivity and error resolution in fast-paced healthcare environments. Adept at collaborating with cross-functional teams, supporting staff with process improvements, and maintaining exceptional customer service standards.

Currently pursuing Certified Medical Coder credentials to further enhance expertise in medical coding, insurance compliance, and billing optimization.

Overview

10
10
years of professional experience

Work History

Rep III Clinical Support Prior Auth/Appeals Administration

CVS Caremark
WHF
12.2021 - 10.2024

During my time at CVS Caremark, I developed a strong expertise in healthcare operations, quality control, and process improvement. My key contributions included:

  • Proficient CAS System Operation: Navigated the CAS software system with ease, ensuring efficiency and accuracy in daily tasks.
  • Quality Control & Team Support: Sent detailed quality control emails to teammates, providing guidance, and reinforcing best practices.
  • Strong Comprehension and Accuracy: Reviewed work instructions with a deep understanding, ensuring adherence to protocols, and minimizing errors.
  • Error Resolution & Compliance: Identified discrepancies in clinical documents and promptly sent corrective requests to Clinical Documentation (CD) to maintain compliance and accuracy.
  • Process Improvement & Collaboration: Actively participated in team meetings, offering insights on workflow enhancements to improve departmental efficiency.
  • Complex Problem-Solving: Investigated intricate question sets, demonstrating attention to detail, and maintaining high levels of accuracy.
  • Effective Time Management: Prioritized workload efficiently to meet deadlines, and ensure timely completion of all assigned tasks.

My experience at CVS Caremark strengthened my analytical skills, attention to detail, and ability to collaborate effectively within a team. These accomplishments have prepared me to excel in roles requiring precision, problem-solving, and a commitment to quality in healthcare operations.

Laboratory Data Administrative Specialist

EcoLab/Nalco
Naperville
05.2019 - 10.2020

In my role, I developed strong administrative, organizational, and analytical skills while supporting laboratory operations. My key contributions included:

  • LIMS Software Proficiency: Accurately logged Legionella and MicroBio samples into the LIMS software, ensuring proper tracking, and data integrity.
  • Sample Management & Organization: Organized, labeled, and filed sample worksheets systematically to maintain efficiency and easy retrieval of records.
  • Account Support and Communication: Managed and responded to incoming emails from sales representatives regarding account inquiries, providing timely and accurate assistance.
  • Data Accuracy & Report Correction: Researched sample data, and corrected reports when necessary to ensure precision and compliance.
  • Administrative Excellence: Provided high-quality administrative support, contributing to the smooth operation of laboratory processes.
  • Compliance & Sample Disposal: Ensured proper disposal of out-of-date samples, maintaining a clean and organized work environment.

This role strengthened my attention to detail, problem-solving skills, and ability to manage multiple tasks efficiently. My experience in data management and administrative support has prepared me to take on more complex roles in healthcare and laboratory operations.

Data Entry/QC-Quality Control

Alverno Clinical Laboratory
Hammond
09.2015 - 05.2019

In my role, I demonstrated strong analytical, problem-solving, and multitasking abilities while supporting the data entry and laboratory operations. My key accomplishments included:

  • Maximized Productivity: Achieved peak efficiency in the data entry department by maintaining accuracy and speed in processing laboratory data.
  • Data Entry & Staff Support: Provided essential support to the data entry team by communicating effectively, and researching issues related to problematic specimens and hospital accounts.
  • Test Validation & Compliance: Reviewed and determined the validity of physician-ordered tests to ensure accuracy and adherence to medical guidelines.
  • Specimen Resolution & Troubleshooting: Investigated and resolved pending specimens, minimizing processing delays, and improving workflow efficiency.
  • Specimen Processing & Testing Coordination: Completed add-on testing, and ensured samples were properly processed for accurate and timely results.
  • Error Resolution and Quality Control: Identified problematic specimens, worked with physicians to correct errors, and facilitated re-submission for accurate testing.
  • Laboratory Billing & Compliance: Managed billing for all tests, ensuring accuracy in patient accounts, and compliance with insurance guidelines.
  • Proficiency in Software Systems: Efficiently utilized multiple software programs, including Epic and Atlas, to manage laboratory data, billing, and patient records.
  • Histology & Cytology Processing: Consistently processed AP specimens, including Pap smears, HPV testing, and GC testing, contributing to accurate diagnostic outcomes.

This role strengthened my ability to work in a fast-paced healthcare environment, ensuring precision, efficiency, and high-quality patient care through meticulous data entry and laboratory coordination.

Patient Access

Porter Regional Hospital
Valparaiso
06.2014 - 05.2015

In my role, I developed strong skills in patient registration, insurance verification, and financial processing while ensuring efficiency in a fast-paced healthcare environment. My key accomplishments included:

  • Insurance & Workers' Compensation Verification: Verified workers' compensation coverage, as well as private insurance, Medicaid, and Medicare, to ensure patients received accurate benefits.
  • Financial Estimates & Patient Communication: Utilized multiple software systems to provide cost estimates for outpatient services, and explain Explanation of Benefits (EOBs) and Advanced Beneficiary Notices (ABNs) to patients.
  • Payment Collection & Processing: Collected co-payments, deductibles, and co-insurance, handling up to $1,000 daily in patient payments.
  • Patient Registration and Data Accuracy: Registered patients quickly and efficiently within the high-volume Emergency and Outpatient Registration department, ensuring accuracy in all records.
  • Professionalism and Timely Service: Maintained a professional and courteous approach while ensuring all patients were recorded promptly and with the utmost care.
  • Cash Handling & Financial Accountability: Managed the admitting department’s cash deposits at the end of each shift, ensuring all transactions were properly documented and reconciled.

This experience strengthened my ability to work under pressure, handle sensitive financial transactions with accuracy, and provide excellent patient service while navigating complex insurance and billing procedures.

Education

Bachelor of Arts - Healthcare Administration

Ashford University
San Diego, CA
08.2016

Associate’s degree - Medical Billing and Coding

Taylor Business Institute
Chicago, IL
06.2005

Skills

Administrative support, appeals, communication skills, compliance, counseling, CPT, data entry, detail-oriented, HIPAA, hospital, ICD-10, medical terminology, prior authorization, Error resolution, Quality control, Customer Service

Timeline

Rep III Clinical Support Prior Auth/Appeals Administration

CVS Caremark
12.2021 - 10.2024

Laboratory Data Administrative Specialist

EcoLab/Nalco
05.2019 - 10.2020

Data Entry/QC-Quality Control

Alverno Clinical Laboratory
09.2015 - 05.2019

Patient Access

Porter Regional Hospital
06.2014 - 05.2015

Bachelor of Arts - Healthcare Administration

Ashford University

Associate’s degree - Medical Billing and Coding

Taylor Business Institute
Rachel N. Malvin