Abigail Gaona Villegas
Red Oak,TX
Summary
Rational CDM Analyst with 1 years of experience enhancing operations for organizations through information systems solutions. Proven track record of transforming specific business goals related to growth and efficiency improvements into new system designs. Experienced analyst prepared for this role with strong focus on data interpretation, financial modeling, and strategic planning. Known for collaboration and delivering results, adaptable to changing needs, and reliable. Skilled in data visualization, problem-solving, and stakeholder communication. Employers value analytical mindset, teamwork, and consistent performance.
Overview
9
9
years of professional experience
Work History
PFS Revenue Integrity CDM Analyst/ Auditor
Parkland Health
01.2024 - Current
- Analyzed and worked request in the CDM workflow from Inpatient and outpatient departments to create charges
- Used EAP, UBE, status indicators, PC/TC indicators
- Performed Audits for five departments as assign by leader
- Created and processed Vital Ware request as requested by departments
- Researched for HCPS and CPT codes for correct processing
- Worked closely with HB team to ensure correct item upload
- Submitted Service Now ticket through Self-Service Portal
- Validating charges though Service Now
- Utilized MPFS Fee schedule, APC pricing, and SAF 50 pricing to ensure correct pricing based on Medicaid and CMS guidelines
- Educated department staff on proper ways of submitting a request
- Performed final review on approved Vital ware request
- Charge Capture, reviewing medical record and adding coding as needed to create proper charges
- Updating Database with current policies and procedure
- Processed, researched, and updated all supply description, Vendor information through Lawson. Access GUDID, and Epic Production
- Collaborated with cross-functional teams to identify opportunities for process improvement and increased efficiency.
- Improved internal knowledge sharing by developing comprehensive documentation outlining standard operating procedures for various tasks.
- Increased efficiency by streamlining data analysis processes and implementing automation tools.
- Managed multiple projects simultaneously while adhering to strict deadlines and quality standards.
- Streamlined reporting processes, significantly reducing time required to generate insights.
Health Unit Coordinator
Parkland Hospital
07.2021 - 01.2024
- Answering phone calls to help patients with appointment needs or routed calls to appropriate department
- Medical Records data entry and record management
- Request medical records with ROI from outside facilities and once received, filed in both Epic and spreadsheet
- Processed outside OB referrals and coordinate appointments
- Worked on appointment request from in patient discharges through In-basket system
- Precept new employees
- Managed all incoming faxes within department
- Assisted nursing staff with daily tasks, contributing to a well-organized and efficient unit environment.
- Managed multiple priorities simultaneously while maintaining attention to detail under pressure in a fast-paced healthcare environment.
- Increased efficiency in the workplace by training new Health Unit Coordinators on policies, procedures, and software applications.
- Served as an integral part of the health unit by willingly taking on additional responsibilities as needed, demonstrating adaptability and teamwork.
PT PFS Collections
Children's Medical Center
05.2019 - 07.2021
- Worked on twelve different claim work queues
- Checked claim status by calling insurance companies and online third-party websites
- Re-process claims or routed to correct queues for coding errors
- Created claim adjustments if needed
- Advised clients on portfolio allocation and various investment types.
- Evaluated financial reporting systems, accounting and collection procedures and investment activities to make recommendations for changes to procedures, operating systems, budgets and other financial control functions.
Radiology Scheduler
Methodist Dallas
12.2018 - 05.2019
- Coordinate patient appointments
- Verified insurance coverages
- Processed referrals and added CPT codes
- Sent out outstanding billing information to insurances for payment
- Coordinated radiology appointments for multiple departments, ensuring optimal resource utilization.
- Promoted a culture of continuous improvement within the scheduling department by actively participating in team meetings and offering constructive feedback on current processes.
Referral Coordinator & Account Specialist
Parkland
03.2016 - 11.2018
- Scheduled and coordinate appointments from referrals
- Input consent forms to health records
- Aid patient with billing questions, verified insurance, entered CPT codes when needed
- Processed and recording transactions
- Scheduled appointments with specialists on behalf of clients.
- Demonstrated strong attention to detail and organizational skills in managing a high volume of referrals while maintaining exceptional levels of patient care.
Education
Health Training Program - Medical Assisting
PCI Training
DallasGED -
TEA
No Degree -
Mountain View College
Dallas, TXSkills
- Bilingual (English & Spanish)
- Medical Office
- Business Office
- Customer Service
- Record keeping
- CMS guidelines understanding
- Deficiency Analysis
- Patient Access
- Billing
- Insurance
- Appointment scheduling
- Extensive Medical terminology
- Clerical
- EPIC production
- MS Word
- Excel
- My Ability
- MS Office
- Eagle Soft
- Cisco Finesse
- TMHP
- PHCS discount
- Kronos
- PowerPoint
- Vital Ware
- Service Now
- Diligence
- Knowledge of CPT and HCPCS codes
- Revenue Integrity
- Charge Description Master
- Access GUDID
- Lawson/ INFOR
- Knowledge of PC/TC indicators
- Auditing
- Highly flexible
- Self-directed
- Ability to critically analyze problems
- Charge Capture
- Updating Database
- Knowledge of CMS
- Medicaid guidelines
- Analytical Thinking
- MS Excel
- Team Collaboration and Leadership
- Documentation And Reporting
- Excel proficiency
- Data Processing
- Report Preparation
- Workflow Analysis
- Multiple Priorities Management
- Audit Support
- Multitasking Abilities
- Excellent Communication
- Problem-Solving
- Attention to Detail
- Time Management
- Process Improvement
- Team Collaboration
- Adaptability and Flexibility
Accomplishments
- Achieve high rating by completing request with accuracy and efficiency.
References
- Sandra Ramirez, Sr100195@gmail.com, 214-498-9168
- Bettina Johnson, johnsonbettina@sbcglobal.net, 469-682-7290
- Janeth Ramirez, Kevinykayla214@gmail.com, 214-545-7935
- Sonya Vera, Sonya.vera13@gmail.com, 210-803-6879
Leadership Experience
- Employee Appreciation Committee
- Volunteer at J. T Brasher Elementary School
- Volunteer at Kiest Park Recreation Center
- Child Passenger Safety Technician Program
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
PFS Revenue Integrity CDM Analyst/ Auditor
Parkland Health
01.2024 - Current
Health Unit Coordinator
Parkland Hospital
07.2021 - 01.2024
PT PFS Collections
Children's Medical Center
05.2019 - 07.2021
Radiology Scheduler
Methodist Dallas
12.2018 - 05.2019
Referral Coordinator & Account Specialist
Parkland
03.2016 - 11.2018
Health Training Program - Medical Assisting
PCI Training
GED -
TEA
No Degree -
Mountain View College