Dena Rubio
Duncanville,TX
Summary
OBJECTIVE: To obtain a challenging and rewarding position with the potential for growth in the medical administrative field, where I can utilize my experience and great customer service skills.
Overview
23
23
years of professional experience
Work History
Reimbursement Specialist Sr.
UT Southwestern
11.2021 - Current
- Analyzed patient data to ensure accuracy of reimbursement information.
- Responded to customer inquiries regarding the status of their reimbursement requests.
- Ensured compliance with applicable laws and regulations when processing reimbursement requests.
- Provided feedback on any changes made to the system used to track reimbursements.
- Determined medical necessity using individual insurance carrier regulations.
Reimbursement Specialist
PeopleSoft, UT Southwestern
09.2017 - Current
- Knowledge and use of Epic, CareGate,, Review and submit charges for Oral and Maxillofacial Surgery, General and Acute Surgery, and Pediatric Surgery.
- Work and resolve denials for the Oral and Maxillofacial Surgery and General and Acute Surgery.
- Post payments to patients accounts.
- Reconcile surgery schedules.
- Review documentation and submit charge to the carrier for payment.
- Credentialing for Commercial and Medicaid insurances.
- Insurance Appeals.
- Research patient and insurance refunds.
- Resolve registration errors.
- Abstracting surgical charges UT Southwestern- Oral and Maxillofacial Surgery Clinic.
Reimbursement Specialist
09.2008 - 09.2017
- Review and submit charges for Oral and Maxillofacial Surgery clinic.
- Work and resolve denials for the Oral and Maxillofacial Surgery clinic.
- Post payments to patients accounts.
- Review documentation and submit charge to the carrier for payment.
- Internal and external referrals.
- Scheduling patients for the clinic including in-office procedures and the OR procedures.
- Provide back up to other clinical staff during peak time.
- Insurance verification for medical and dental.
- Obtain benefits and out of pocket costs for patient prior to procedures.
- Obtain any prior authorizations needed prior to surgery and/or in-office procedures.
- Register new patients into the EPIC system.
- Check in/out patients.
Insurance verification
Husba Iqbal, M.D.P.A
DeSoto, TX
03.2001 - 09.2008
- Obtain pre-certification for outpatient procedures.
- Check in/Check out patients.
- Reviewing and submitting charges.
- Manual charge entry.
- Responsible for releasing medical records.
- Medication refills and prior authorizations, if needed.
- Scheduling appointments
- Insurance appeals.
- External referrals.
- Obtaining patient vitals.
- Time reporting and bookkeeping
Medical Office Assistant
Husna Iqbal, M.D.P.A
03.2001 - 09.2008
Clinic Staff Assistant I, II, and III
Skills
- Benefits
- Bookkeeping
- Oral
- Documentation
- Insurance
- Office
- Peak
- Reporting
- Research
- Scheduling
References
References available upon request
Timeline
Reimbursement Specialist Sr.
UT Southwestern
11.2021 - Current
Reimbursement Specialist
PeopleSoft, UT Southwestern
09.2017 - Current
Reimbursement Specialist
09.2008 - 09.2017
Insurance verification
Husba Iqbal, M.D.P.A
03.2001 - 09.2008
Medical Office Assistant
Husna Iqbal, M.D.P.A
03.2001 - 09.2008
Clinic Staff Assistant I, II, and III
Similar Profiles
Kevin CummingsKevin Cummings
Social Work Intern at Ut Southwestern UT Outpatient Psychiatry ClinicSocial Work Intern at Ut Southwestern UT Outpatient Psychiatry Clinic
Carol CalixCarol Calix
Imaging Registered Nurse at UT SouthwesternImaging Registered Nurse at UT Southwestern
Kevin Antonio Luna CastillaKevin Antonio Luna Castilla
Housekeeper at UT SouthwesternHousekeeper at UT Southwestern
Tracy DawsonTracy Dawson
Respiratory Therapist at UT SouthwesternRespiratory Therapist at UT Southwestern
Ricardo PadillaRicardo Padilla
Ground Support Operator at Randstadt TechnologiesGround Support Operator at Randstadt Technologies