Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Elizabeth DE LA FUENTE

HOUSTON,TX

Summary

Efficient Patient Service Representative with 30 years of experience working in hospital/clinic facility's. Extensive knowledge of medical record organization and patient advocacy. Successful at helping patients through every step of the healthcare process. Efficient and attentive Patient Service Coordinator capable of pulling charts, processing payments and managing procedure schedules. Ready to bring strong communication, organizational and multitasking abilities to a challenging new role in a fast-paced environment.

Overview

16
16
years of professional experience
1
1
Certification

Work History

Senior Scheduler

Houston Methodist
08.2022 - Current
  • Streamlined scheduling processes by implementing efficient software solutions, resulting in improved project timelines.
  • Coordinated cross-functional teams for seamless project execution and timely delivery of key milestones.
  • Optimized resource allocation with strategic planning, reducing project costs and maximizing team productivity.
  • Devised comprehensive schedules, ensuring all project deadlines were met and exceeded client expectations.
  • Managed change requests effectively by assessing impacts on schedule baselines while maintaining open dialogue with relevant parties throughout the process.
  • Flagged potential issues by monitoring timelines.

Patient Service Representative

UT Physicians
06.2019 - 09.2020
  • Coordinated between patients and healthcare professionals to meet patient needs.
  • Utilized customer service skills and detailed system knowledge to support hospital and clinic operations.
  • Scheduled and confirmed patient appointments with patients and healthcare professionals.
  • Checked claims for errors, corrected issues and mailed out promptly.
  • Checked daily doctor schedules and verified insurance.
  • Educated patients and families on treatments, procedures, medications, continuing care and community resources.
  • Accessed patient information through variety of office software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
  • Ran credit card batches and balanced deposits on a daily basis.
  • Referred patients to appropriate professionals and services.
  • Improved operations by working with team members and customers to find workable solutions.

Financial Clearance Associate

MD Anderson Cancer Center/ObjectWin
06.2018 - 07.2019
  • Financial Clearance Associate is responsible for creating a positive patient experience by accurately and efficiently handling the day to day operations relating to financial clearance activities.
  • This includes adherence to the department's policies and procedures related to the verification of eligibility/benefits, Pre-authorization requirements, financial counseling and other identified financial clearance related duties.
  • Also responsible for timely escalating registration/financial clearance issues to the Financial Clearance Manager/Supervisor for resolution.

Insurance Verification Specialist

WEST HOUSTON SURGICARE
03.2017 - 02.2018
  • Responsible for verifying all patient and insurance demographic information, obtain insurance coverage.
  • Pre-authorization for in-patient and out patient.
  • Verification and pre-certification from the insurance company, when required.
  • Quotes the facility fees, to the.
  • Verifies insurance eligibility and benefits and ensures all notifications and authorizations are completed.
  • Patient, required at time of service, prepares the check-off sheet and creates the patient medical record.
  • Received and routed business correspondence to correct department or staff member.
  • Greeted incoming customers in a professional manner and provided friendly, knowledgeable assistance.
  • Answered telephone inquiries from clients, vendors and the public.
  • Provided clerical support to company employees, including copying, faxing and file management.
  • Answered and quickly redirected up to 3-6 calls per 1-2 minutes.

AEROTEK: OBSTETRIX MEDICAL GROUP Insurance Biller
12.2016 - 03.2017
  • Scheduled appointments, registered patients and distributed sample pharmaceuticals as prescribed.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Correctly coded and billed medical claims for various hospital and nursing facilities.
  • Verifies insurance eligibility and benefits and ensures all notifications and authorizations are completed.
  • Thoroughly researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.
  • Professionally and courteously verified appointment times with patients.
  • Assisted in the maintenance of medical charts and/or electronic medical record (filing, Op Reports, test results, home care forms).
  • Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
  • Adeptly managed a multi-line phone system and pleasantly greeted all patients.
  • Verified patients' eligibility and claims status with insurance agencies.
  • Entered orders into the EMR system efficiently and without errors.
  • Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient.
  • Medical records.
  • Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.

Service Linkage Worker

HARRIS HEATH SYSTEM
03.2008 - 12.2015
  • Scheduled appointments, registered patients and distributed sample pharmaceuticals as prescribed.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Verifies insurance eligibility and benefits and ensures all notifications and authorizations are completed.
  • Correctly coded and billed medical claims for various hospital and nursing facilities.
  • Thoroughly researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.
  • Professionally and courteously verified appointment times with patients.
  • Assisted in the maintenance of medical charts and/or electronic medical record (filing, Op Reports, test results, home care forms).
  • Adeptly managed a multi-line phone system and pleasantly greeted all patients.
  • Verified patients' eligibility and claims status with insurance agencies.
  • Entered orders into the EMR system efficiently and without errors.
  • Determined prior authorizations for medication and outpatient procedures.
  • Pre-certified medical and radiology procedures, surgeries and echocardiograms.
  • Achieved departmental goals by developing and executing strategic plans and performance metrics.
  • Increased team productivity by implementing streamlined processes and effective communication strategies.

Education

Certificate of Technology for Medical Billing and Coding. Coursework in Healthcare Management Certificate in Health Information Administration Coursework in Medical Front Office Assisting Health Information Technician (RHIT) coursework -

Medical Billing and Coding San Jacinto College Houston Texas -

ASSOCIATE OF APPLIED SCIENCE
2019

Skills

Experienced in billing and collection procedures Advanced medical terminology knowledge Patient referrals expert history-taking, physical examination, clinical investigations, using diagnostic reasoning, procedural perfection, effective communication, team work and professionalism

  • Medical office settings Advanced knowledge of private insurance processes and codes Medical terminology expert
  • ICD-10 (International Classification of Disease Systems
  • Billing and collection procedures expert

HCPCS Coding Guidelines

  • Familiar with commercial and private insurance

Certification

CPR certified through American Heart Association Healthcare Management Certificate Certified Medical Assistant Phlebotomist Epic and Windows NextGen and PrognoCIS Advantx Availity I-Exchange Passport

Timeline

Senior Scheduler

Houston Methodist
08.2022 - Current

Patient Service Representative

UT Physicians
06.2019 - 09.2020

Financial Clearance Associate

MD Anderson Cancer Center/ObjectWin
06.2018 - 07.2019

Insurance Verification Specialist

WEST HOUSTON SURGICARE
03.2017 - 02.2018

AEROTEK: OBSTETRIX MEDICAL GROUP Insurance Biller
12.2016 - 03.2017

Service Linkage Worker

HARRIS HEATH SYSTEM
03.2008 - 12.2015

Certificate of Technology for Medical Billing and Coding. Coursework in Healthcare Management Certificate in Health Information Administration Coursework in Medical Front Office Assisting Health Information Technician (RHIT) coursework -

Medical Billing and Coding San Jacinto College Houston Texas -

ASSOCIATE OF APPLIED SCIENCE

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Elizabeth DE LA FUENTE