Summary
Overview
Work History
Education
Skills
Awards
Timeline
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Erica Gafford

Dallas,TX

Summary

Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.

Overview

24
24
years of professional experience

Work History

Full-time Caregiver

01.2022 - 11.2024
  • This is to explain 2-year time gap in employment
  • Took time away from my professional career to act as full-time caregiver to a relative who became ill.
  • Assisted relative with daily tasks such as bathing, dressing and grooming.
  • Checked vital signs on a regular basis to gauge recovery progress.
  • Administered medications three times daily.

Insurance Specialist II

UT SOUTHWESTERN MEDICAL CENTER
08.2013 - 01.2022
  • Provided administrative clerical support to include but not limited to processing office mail ensuring items are delivered to appropriate recipients, credentialing verification, documenting prep, editing memos and data entry.
  • Obtained radiology authorizations from Medicare/Medicaid/Government/Commercial insurance for patient imaging tests prior to arrival. Also counseled patients when an out-of-network instance occurs or other potential payor technicalities arose.
  • Maintained purchasing of office supplies, equipment and furniture.
  • Received incoming calls per ACD line from patients with customer service issues as they arose resulting in 100% patient satisfaction as well as responded to patient inquiries via email and chat in a timely manner, courteous and professional matter.
  • Handled billing inquiries, utilized Epic Resolute software, scanned, filed and fax medical documents ensuring compliance with all HIPPA guidelines.
  • Increased patient satisfaction by 30% due to delivery of quick service and quick resolution of issues as they arose.

Senior Clinical Assistant/Billing Specialist

UT SOUTHWESTERN MEDICAL CENTER
11.2000 - 08.2013
  • Requested medical records for appropriate uses by providers to assess healthcare diagnosis code assessment.
  • Received a large volume of calls that consisted of patient complaints that may pertain to all phases of operations including billing, claims denials, payment and collection activities.
  • Coordinated patient appointments and follow-up visits for optimal care continuity.
  • Verified medical benefits, collected co-pays, posted cash and credit card payments and processed online billing.
  • Assisted in training new staff on billing procedures and software usage.
  • Investigated incorrect billings and processed refunds as necessary on CMS-1450 Forms.
  • Managed patient records and ensured accurate documentation in electronic systems.
  • Provided prompt response to inbound inquiries from staff, employees internally via Outlook and performed other duties assigned by management team.

Education

Medical Billing and Terminology Certification Program

El Centro Community College
05.2000

Skills

  • Insurance verification/Prior Authorization/Referrals
  • ACD phones lines and EHR systems
  • Microsoft Office/Microsoft Word, Microsoft PowerPoint, Microsoft Excel, Outlook management, Adobe Acrobat, People Soft
  • Medical Terminology and Billing/Knowledge of ICD 10 Coding
  • Time management/Medical records management
  • HIPPA Compliance/Epic Resolute
  • Customer service and conflict resolution
  • Database Management/Inventory Management

Awards

UT Southwestern 2016, 2017, 2018 Received PACT Award for Best Problem Solver, Best Attitude, Best Communicator, Best Team Worker.

Timeline

Full-time Caregiver

01.2022 - 11.2024

Insurance Specialist II

UT SOUTHWESTERN MEDICAL CENTER
08.2013 - 01.2022

Senior Clinical Assistant/Billing Specialist

UT SOUTHWESTERN MEDICAL CENTER
11.2000 - 08.2013

Medical Billing and Terminology Certification Program

El Centro Community College

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Erica Gafford