Abigail Gutierrez
San Antonio,Tx
Summary
Detail-oriented healthcare professional with experience providing exceptional customer service in a fast-paced healthcare environment. Skilled in researching and resolving member inquiries, navigating multiple systems simultaneously, reviewing healthcare information for accuracy, and maintaining compliance with privacy regulations. Proven ability to meet productivity and quality standards while delivering a positive member experience. Seeking to leverage healthcare operations and customer services expertise in a claims Representative role.
Overview
10
10
years of professional experience
Work History
Inbound Contacts Representative
Humana
San Antonio, TX
11.2024 - Current
- Addressed member inquiries regarding benefit authorization referral claims and coverage, delivering exceptional customer service and support.
- Conducted thorough reviews of member information and documentation to guarantee precision and compliance with HIPAA and organizational standards.
- Navigate multiple systems simultaneously while maintaining productivity and quality performance metrics.
- Demonstrate strong attention to detail, time management, and organized skills in a fast-paced environment.
- Support administrative processes related to authorizations, referrals, and healthcare coordination.
- Collaborate with internal departments and healthcare partners to resolve complex issues and ensure timely follow-up.
- Build rapport with members and providers through effective communication, empathy, and problem-solving skills.
Medical Assistant
University Health System
San Antonio, TX
02.2016 - 11.2024
- Coordinated patient referrals, authorization support, appointment scheduling, and medical record documentation.
- Maintained accurate patient charts and electronic medical records while ensuring confidentiality and HIPPA compliance.
- Processed referrals and utilized ICD-10/CPT coding knowledge to support patient care coordination.
- Assisted providers with administrative and clinical support in fast-paced healthcare settings.
- Transcribed physician reports into electronic health record systems accurately and efficiently.
- Cross-trained in pediatrics and adult care, including newborn clinic support and specialty patient assistance.
- Supported physicians during in-office procedures and assisted with patient care coordination.
- Performed administrative duties including data entry, answering phones, supply management and patient intake coordination.
Education
Medical Assistant -
Everest Institute
Georgia03-2013
High School Diploma -
Highlands High School
San Antonio, TX05-2009
Skills
- Claims Research & Resolution
- Healthcare Customer Service
- Utilization Management Support
- Prior Authorization & Referral Coordination
- Administrative Coordination
- Medical & Insurance Terminology
- HIPPA & Confidentiality Compliance
- Electronic Medical Records (EMR/EHR)
- Data Entry & Documentation
- Microsoft Office Suite
- Multi-System Navigation
- Scheduling Coordination
- Problem Resolution
- Quality & Performance Metrics
- Time Management & Multitasking
- Atten to Detail
Timeline
Inbound Contacts Representative
Humana
11.2024 - Current
Medical Assistant
University Health System
02.2016 - 11.2024
Medical Assistant -
Everest Institute
High School Diploma -
Highlands High School