Fidela Gaitan
Pasadena,TX
Summary
Certified medical billing specialist with 22 years of experience in dynamic medical settings. Expertise in claims processing, denial management, and patient communication drives operational efficiency and enhances patient satisfaction. Proficient in ICD-10-CM coding and revenue cycle management, ensuring accurate billing and compliance with industry standards.
Overview
29
29
years of professional experience
Work History
Patient Customer Support Specialist
Parallon Revenue Cycle
01.2017 - Current
- Greet patients upon arrival, verify personal and insurance details, and ensure all paperwork is accurate and complete.
- Answered incoming calls promptly and professionally, enhancing patient experience.
- Facilitated effective communication between patients and healthcare professionals, ensuring clear message delivery.
- Address and resolve patient concerns promptly to improve satisfaction.
- Identified accurate insurance plans and informed patients of out-of-network options to ensure informed decisions.
- Explained charges and set up payment plans or financial assistance programs.
- Ensure all required information is accurate and complete in the practice management tool/EMR.
- Maintain patient records with confidentiality and compliance with healthcare regulations.
Customer Service Representative
PHN MSO Coder Bayshore -Kirkwood Medical Associates; PSG Coder I WFH-TN Healthcare MGMNT. INC
03.2006 - 01.2017
- Abstracts all necessary information and assigns codes (ICD-10, CPT& HCPCS), which most accurately describe each documented diagnosis, surgical procedures according to established guidelines.
- Evaluates the record for documentation consistency and adequacy.
- Ensure that the final diagnosis accurately reflects the care and treatment given.
- Resolve coding related denials.
Kirkwood Medical Associates
Pasadena, TX
02.1997 - 02.2006
- Review and code designated office notes for multiple providers.
- Work with AR to resolve coding related denials.
- Ensure charge information provided is correct.
- Professionally and courteously verified appointment times with patients.
- Aided in the maintenance of medical charts.
- Processes patient referrals to specialty providers by preparing medical charts and records for referral patient visits and providing proper clinical information to specialists.
- Obtain authorizations for patient referrals to specialists, diagnostic testing, and procedures.
Education
GED -
Charles M. Milby Senior High School
Houston, TX01-1994
Skills
- ICD-10-CM coding
- CPT and HCPCS coding
- Revenue cycle management
- Insurance verification
- Claims processing
- Denial management and resolution
- Medical records review
- EMR/EHR systems
- HIPAA compliance
- Patient account resolution
- Communication skills
- Adaptive learner
- Prior authorizations
- Referral coordination
- Data entry and documentation
- Microsoft Office Suite
- Client relations
- Medical terminology knowledge
- People skills
- Compassionate professional
- Open-minded and adaptable
- Dedication to excellence
- Clinical judgment
- Patient-focused care
- Meticulous and organized
Timeline
Patient Customer Support Specialist
Parallon Revenue Cycle
01.2017 - Current
Customer Service Representative
PHN MSO Coder Bayshore -Kirkwood Medical Associates; PSG Coder I WFH-TN Healthcare MGMNT. INC
03.2006 - 01.2017
Kirkwood Medical Associates
02.1997 - 02.2006
GED -
Charles M. Milby Senior High School