Gabriela Aburto
Moti Physiotherapy
Maywood,CA
1
Language
10
years of professional experience
Revenue Cycle Specialist with 6+ years of experience in insurance verification, prior authorization, medical billing, and collections, driving improved cash flow and reduced accounts receivable aging. Expertise in HIPAA-compliant collections, ERA posting, EOB analysis, insurance verification, denial follow-up, and EMR systems. Proven ability to streamline revenue cycle workflows, train and lead staff, improve recovery performance, and support organizational financial goals. Bilingual professional with strong proficiency in Excel and healthcare revenue cycle processes.
Work History
Revenue Cycle Specialist
5 Years 10 Months- Reviewed patient accounts for billing accuracy, coding errors, and missing documentation.
- Managed insurance claim submissions, denials, and resubmissions for physiotherapy services.
- Used the following websites to verify Insurance benefits and review claims: Noridian, Availity, Blue Shield, Health Net, USAA, AARP, UHC, Maritain Health, and Inovalon Clearinghouse
- Posted payments, reconciled remittances, and resolved account discrepancies.
- Followed up on outstanding balances with patients and insurance carriers.
- Verified eligibility, benefits, and authorization requirements before claims processing.
- Maintained compliance with billing policies, payer guidelines, and collection procedures.
- Trained staff on claim status tracking and account resolution workflows.
- Improved collections efficiency through organized follow-up and timely issue resolution.
- Reduced claim denials by diligently reviewing patient records for correct coding and billing information.
- Provided exceptional customer service to patients regarding their account balances, addressing concerns and answering questions in a professional manner.
- Responded to customer concerns and questions on a daily basis.
- Collaborated with customers to resolve disputes.
- Maintained accurate records of customer payments.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
- Reviewed medical records and payer criteria to verify authorization requirements and prevent processing delays.
- Resolved denials and appeals by gathering supporting documentation and clarifying medical necessity.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Audited patient records for accuracy, completeness, and compliance with HIPAA requirements.
- Coordinated release-of-information requests while verifying authorization and confidentiality standards.
- Trained new staff on records procedures, retention standards, and document handling protocols.
- Improved workflow consistency by standardizing record review and scanning processes.
- Communicated with clinicians, billing teams, and patients to clarify documentation needs and record status.
- Coordinated responses to subpoenas and other legal requests for medical records, working closely with legal counsel as necessary to protect patient privacy rights.
- Processed medical records requests from outside providers according to facility, state, and federal law.
- Uploaded physician progress notes, history, and physicals into electronic medical records.
- Reviewed charts and flagged incomplete or inaccurate information.
- Posted insurance and patient payments accurately to accounts using practice management systems.
- Resolved rejected claims by analyzing payer edits and correcting supporting documentation.
- Interpreted EOBs and remittance advice to apply payments and identify underpayments.
- Coordinated with registration, coding, and billing teams to improve revenue cycle workflow accuracy.
- Advised staff on payer requirements, documentation standards, and denial resolution procedures.
- Increased revenue by identifying and resolving billing errors in a timely manner.
- Balanced and reconciled accounts.
Patient Care Coordinator and Medical Biller
1 Year 1 Month- Coordinated patient intake, appointment scheduling, and follow-up communications for physiotherapy services.
- Communicated with patients regarding treatment plans, visit requirements, and clinic policies.
- Managed medical records, consent forms, and treatment documentation with accuracy and confidentiality.
- Supported therapists by organizing daily caseloads and resolving scheduling conflicts efficiently.
- Improved office efficiency by refining scheduling, reminder, and record-keeping processes.
- Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
- Provided exceptional customer service by addressing concerns, answering questions, and ensuring patient satisfaction with their care experience at the clinic.
- Trained new staff members on office procedures and protocols, ensuring consistency in patient care delivery.
- Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
Human Resource File Clerk
1 Month- Processed new hire paperwork and maintained compliance with hospital recordkeeping standards.
- Scanned, indexed, and updated confidential HR records in electronic filing systems.
- Audited file contents for completeness, correcting discrepancies and missing documentation.
- Organized employee personnel files, ensuring accurate retrieval and secure document storage.
Valet Parking Supervisor
2 Years 5 Months- Supervised valet attendants, ensuring smooth vehicle retrieval and consistent customer service.
- Trained new team members on parking procedures, safety practices, and guest interaction standards.
- Monitored parking flow, directing staffing adjustments to reduce congestion during peak service periods.
- Resolved guest concerns promptly, maintaining professionalism and service quality throughout operations.
- Coordinated key control, ticketing, and vehicle tracking to support accurate valet operations.
- Inspected parking areas and vehicles for safety issues, reporting concerns for immediate follow-up.
- Documented incidents, cash activity, and operational updates to maintain accurate supervisor records.
Medical Billing Extern
2 Months- ⬧ Researched CPT and ICD-10 fee information on CMS.gov to support accurate billing decisions.
- Performed phlebotomy and supported nurse visits, ensuring timely specimen collection and patient comfort.
- Researched CPT and ICD-10 fee information on CMS.gov, ensuring accurate billing decisions.
- Processed claims and reviewed patient data, resolving case management issues and minimizing claim errors.
- Posted payer payments for Healthcare LA, ensuring accurate records and timely posting.
Education
Medical Billing And Coding
High School Diploma
Skills
Claims processing
Claims assessment
Claims review
Denial management
Prior authorization processing
Insurance verification
Revenue reconciliation
Medical billing
Payment processing
Electronic health records
Documentation management
Insurance policy management
HIPAA compliance
Healthcare regulations
Patient account management
Statement review
Problem-solving
Analytical skills
Attention to detail
Task management
Team collaboration
Adaptability and flexibility
Communication skills
Languages
English
Native or Bilingual
Timeline
Revenue Cycle Specialist
Moti Physiotherapy
12.2020 - CurrentRead More
Patient Care Coordinator and Medical Biller
Moti Physiotherapy
11.2019 - 12.2020Read More
Human Resource File Clerk
Good Samaritan Hospital Medical Center
09.2019 - 10.2019Read More
Medical Billing Extern
Wesley JWCH Institute, Inc
06.2019 - 08.2019Read More
Valet Parking Supervisor
SP+ Parking
04.2017 - 09.2019Read More
American Career College
Medical Billing And Coding
Read More
Maywood Academy High School
High School Diploma
Read More