Summary
Overview
Work History
Education
Skills
Languages
Languages
Timeline
Generic

Gisela Ascanio

San Antonio,TX

Summary

Accomplished medical professional with over 20 years of experience in healthcare, including a pivotal role at WellMed. Expert in medical billing, coding, and compliance, with a proven track record of reducing account receivables and enhancing operational efficiency. Skilled in technology and effective communication, consistently achieving over 96% vaccination coverage in large-scale initiatives.

Overview

26
26
years of professional experience

Work History

BILLING SPECIALIST

WellMed
SAN ANTONIO, TX
11.2019 - Current
  • Review medical record documentation to identify services provided by physicians & mid-level providers as it pertains to claims
  • Verifies appropriate CPT, ICD, and HCPCS codes to accurately file claims for the physician service using the medical record as supporting document
  • Performs corrections for patient registration information that includes but is not limited to, patient demographics and insurance information
  • Responsible for working EDI claim rejections in a timely manner
  • Receives and interprets EOB that supports payments from Insurance carriers
  • Medicare, or patients
  • Able to apply correctly to claims/fee billed
  • Process incoming EOBs to ensure timely insurance filing/patient billing
  • May require correction of data originally submitted for a claim or Coordination of Benefits with secondary insurance
  • Responsible for processing payments, adjustments and denials according to establishment guidelines
  • Responsible for reviewing insurance payer reimbursements for correct contractual allowable amounts as well as reconciling transactions to ensure that payments are balanced
  • Responsible for reducing account receivables by accurately and thoroughly working assigned accounts in accordance with established policy & procedures
  • Responsible for keeping current with changes in their respective payer’s policies & procedures
  • Communicates with clinics to provide/obtain corrected or additional data
  • Identifies problems and root cause of problems related to billing & collections
  • Responsible for identifying trends/problems in medical documentation and reporting them in a timely fashion
  • Participates with special assigned projects
  • Keeps Medical Coding certification by attending Webex training to obtain CEUs

CREDENTIALING SPECIALIST/HR ASSISTANT

Healthcare, Compliance
SAN ANTONIO, TX
05.2019 - 11.2019
  • Worked with healthcare organizations to ensure providers and their facilities complied with regulations
  • Gathered necessary information such as license number, tax ID, SSN, facility information, as well as what insurance companies they would be accepting, file the paperwork and keep track of any new providers or expiring licenses
  • Assisted the Human Resources department with an onboarding of new staff, setting up for interviews and filing/organizing the paperwork on the share drive.

INDEPENDENT DUTY MEDICAL TECHNICIAN

USAF
SAN ANTONIO, TX
07.2014 - 02.2018
  • Provided routine and emergency medical care to ~ 40K basic military trainees and 500 instructors annually
  • Treated minor medical and surgical conditions and administer medications and immunizations
  • Provide medical coverage for high-risk training and conditioning activities
  • Maintain quarterly medical, dental, administrative, laboratory, pharmacy, and bioenvironmental sustainment training
  • Provided, supervised and managed patient care of active duty personnel to include flying and special operational duty personnel
  • Front-line preventionist who identified potential health risks and provided preventative counseling
  • Performed paraprofessional portions of preventative health assessments and physical examinations
  • Monitored and recorded physiological measurements such as blood pressure, respirations, temperature and oxygen saturation
  • Assembled, initiated, and maintained intravenous therapy
  • Performed basic life support and triage in emergency situations
  • Prepared and submitted administrative reports for Self-Aid & Buddy Care Program
  • Managed supplies and equipment, as well as submitted and executed budgets
  • Provided training to medical and non-medical personnel such as Basic Life Support, Heart Saver, Emergency Medical Technician and Self-Aid & Buddy Care
  • Rendered medical, dental and emergency treatment
  • Performed Public Health duties to include: Medical Intelligence, Communicable Disease Control, Facility Health Inspections, Occupational Health Activities, Deployment Surveillance, Entomology and Food Safety & Security
  • Immunizations Back-up Technician didactics (Principles of Active and Passive Immunities, Active Duty Immunizations, Pediatric Immunizations and Management of Adverse Reactions following Immunizations) and hands-on quarterly training IAW AFJI 48-110 Appendix B
  • Managed computer-based patient information
  • Performed tuberculosis testing and administered vaccines IAW current guidelines to active-duty/reserve/guard personnel their dependents to include pediatrics
  • Provided patient educations regarding expected reactions and proper post-vaccination care
  • Documented vaccines given or transcribed in ASIMS, as well as pulling monthly reports for members who were behind on their Medical Readiness
  • Planned and managed a major 2016 Influenza initiative
  • Directed three vaccine lines to administer 250+ shots and cover 100% of all personnel
  • Standardized processes for auditing medication and supply inventories, which reduced risk associated with expired or unavailable medications and freed up 20 in administrative work
  • Achieved 100% compliance for record keeping by scrutinizing records, eliminating unnecessary documents, correcting discrepancies, and ensuring completion of quarterly training updates.

INDEPENDENT DUTY MEDICAL TECHNICIAN

USAF
GREAT FALLS, MT
07.2011 - 06.2014
  • Provided – as 1 of just 2 IDMTs – medical treatment and administrative assistance for 400+ personnel
  • Managed a $150K equipment package and medical emergency response vehicle
  • Served as Self Aide and Buddy Care (SABC) Program Manager, as well as Unity Health Monitor, with responsibility for tracking compliance
  • Delivered improvements and oversight to optimize patient experiences, reduce risk, and increase regulatory compliance
  • Provided, supervised and managed patient care of active duty personnel to include flying and special operational duty personnel
  • Provided field medical care in contingency operations and disasters
  • Served as member of primary emergency medical response to in-flight emergencies and potential mass casualty scenarios for on and off-base incidents
  • Provides deployment support in developing, planning, and conducting training and evaluations needed to assess squadron readiness, mobility, and deployment requirements
  • Participated in contingency or disaster field training, exercises and deployments
  • Augmented search and rescue flying squadrons
  • Disposed of medical waste
  • Supervised personnel, conducted training and created duty schedules
  • Performed paraprofessional portions of preventative health assessments and physical examinations
  • Performed basic life support and triage in emergency situations
  • Prepared and submitted administrative reports for Self-Aid & Buddy Care Program
  • Managed supplies and equipment, as well as submitted, prioritized and allocated resources
  • Performed assessment and analysis of patient health status, identified health goals, recognized subtle changes in conditions, interpreted these changes, and immediately determined appropriate course of action
  • Provided training to medical and non-medical personnel such as Basic Life Support, Heart Saver, Emergency Medical Technician and Self-Aid & Buddy Care
  • Performed duties as an Independent Duty Medical Technician at home station and deployed locations, remote sites and alternate care locations
  • Established preceptorship and provided forward area health care IAW applicable guidelines in an austere or bare-base environment
  • Performed Public Health duties to include: Medical Intelligence, Communicable Disease Control, Facility Health Inspections, Occupational Health Activities, Deployment Surveillance, Entomology and Food Safety & Security
  • Immunizations Back-up Technician didactics (Principles of Active and Passive Immunities, Active Duty Immunizations, Pediatric Immunizations and Management of Adverse Reactions following Immunizations) and hands-on quarterly training IAW AFJI 48-110 Appendix B
  • Managed computer-based patient information
  • Performed tuberculosis testing and administered vaccines IAW current guidelines to active- duty/reserve/guard personnel their dependents to include pediatrics
  • Provided patient educations regarding expected reactions and proper post-vaccination care
  • Documented vaccines given or transcribed in ASIMS
  • Utilization of ASIMS: pulling monthly reports for members who were behind on their Medical Readiness, puling monthly reports with members on ALC Duty Mobility Restrictions, Pregnancy Profiles as well as members undergoing an MEB process
  • Performed medical administration duties to include: administration of Personnel Reliability Program (PRP), AF Form 1480/DD Form 2766, Health Benefits Program, Line of Duty, Outpatient Records Maintenance, Medical Affirmative Claims/Third Party Liabilities, HIPPA
  • Knowledge of Medical Logistics procedures and Maintenance Medical Supply Account
  • Reduced Primary Care Manager workload 15% by executing squadron duty / assignment limitation codes profile program to validate 255 medical conditions
  • Earned an Air Force Commendation Medal for increasing unity readiness by scheduling an instructing lifesaving courses in SABC and CPR using AED
  • Earned a 99% positive response rate in post-training student evaluations
  • Served as the single provider of medical care for 135 personnel during a mission to Israel, ensuring the health and wellness of the team despite the challenging physical environment.

MEDICAL TECHNICIAN/IBT TECH/FAMILY PRACTICE MANAGER

USAF
San Angelo, TX
10.2006 - 07.2011
  • Assisted medical and nursing teams in planning and delivering medical care for 2.5K patients across 5 units: Pediatrics, Student Clinic, Women’s Health, Immunizations, and Family Health
  • Managed $118K Clinical Medicine budget
  • Performed medical treatments and diagnostics
  • Assisted with specialized exams and minor procedures
  • Provided training to medical and non-medical personnel such as Basic Life Support, Heart Saver, Emergency Medical Technician and Self-Aid & Buddy Care
  • Knowledge of Medical Logistics procedures and Maintenance Medical Supply Account
  • Analyzed problems and assisted in developing written and/or oral recommendations, which considered factors and requirements associated with the eligibility/assessment of medical standards
  • Monitored and recorded physiological measurements such as blood pressure, respirations, temperature and oxygen saturation
  • Observed, reported and recorded observations in patient progress in AHLTA
  • Prepared and submitted administrative reports for Self-Aid & Buddy Care Program
  • Immunizations Back-up Technician didactics (Principles of Active and Passive Immunities, Active Duty Immunizations, Pediatric Immunizations and Management of Adverse Reactions following Immunizations) and hands-on quarterly training IAW AFJI 48-110 Appendix B
  • Managed computer-based patient information
  • Performed tuberculosis testing and administered vaccines IAW current guidelines to active-duty/reserve/guard personnel their dependents to include pediatrics
  • Provided patient educations regarding expected reactions and proper post-vaccination care
  • Worked alongside PCM for preparation of submission of MEB packages for members with chronic medical conditions that may restrict their duty/mobility ability IAW AFI 44-123
  • Disposed of medical waste
  • Supervised personnel, conducted training and created duty schedules
  • Scheduled and/or conducted in-service training on procedures, techniques and equipment
  • Scheduled and/or conducted periodic disaster training, fire drills and evacuation procedures
  • Operated emergency medical and other vehicles
  • Loaded and unloaded litter patients
  • Contributed to providing 4.2K influenza vaccines as part of a major initiative that vaccinated 96% of the Wing
  • Saved the group $3.8K in outsourcing costs by completing a 15-hour colposcopy training, just 1 of 20 techs to complete the training
  • Subsequently developed the group’s first colposcopy procedure tracking system
  • Introduced several initiatives to strengthen team morale, readiness, and ability to serve patients, including a one-to-one mentorship program that resulted in the promotion of two personnel
  • Earned numerous awards, including multiple Airman of the Quarter awards, NCO of the Quarter award, and Airman of the Year in 2007
  • Worked in the healthcare industry for over 20 years with vast experience in EHR, HIPPA, ICD-10, CPT/HCPCS, credentialing, training as well as supervising staff.

MEDICAL TECHNICIAN

USAF
Anchorage, AK
10.2003 - 10.2006
  • Provided medical and administrative support within both a 1,500+ patient Pediatrics Clinic and a Labor and Delivery Unit, an integrated 5-bed labor and delivery suite, intermediate care nursery, and 13-bed surgery unit, and an antepartum clinic
  • Maintained clinical records and managed medical supply operations
  • Admitted, discharged, and transferred patients as directed
  • Oriented patients to hospital environment
  • Coordinated medical service activities with execution and clinical management team
  • Utilized the nursing process for promoting and maintaining patient health
  • Provided disease and disability education, care, and evaluation of nursing care
  • Maintains inpatient and outpatient records
  • Observed, reported and recorded observations in patient progress notes and team conference
  • Performed portions of medical treatment, diagnostic and therapeutic procedures under the supervision of provider
  • Cared for, observed, and reported on pre-post-operative, seriously or critically ill, and injured patients
  • Recorded treatments and procedures rendered and observed effects
  • Monitored and recorded physiological measurements such as blood pressure, respirations, temperature and oxygen saturation
  • Performed postmortem care
  • Identified patient problems and assisted in developing and evaluating patient care plan(s)
  • Participated in contingency or disaster field training, exercises and deployments
  • Disposed of medical waste
  • Served as a SME and peer trainer for challenging IVs and lumbar punctures
  • Trained 14 new personnel to ensure compliance, adherence to standardized procedures, and patient safety
  • Honored with an Achievement Medal for meritorious service for developing a process to perform 400+ pediatric physicals within just 6 days during back to school

FRONT OFFICE/DENTAL ASSISTANT/OFFICE MANAGER

DR GOLDSTEIN, DMD
Windermere, FL
05.1999 - 01.2003
  • Provided a broad range of operational oversight for pediatric dental practice, which included insurance billing, verification, scheduling, interview any new hires, electronic dental records, recovering unpaid claims and inventory management
  • Evaluated the practice to uncover and address operational excellence, strengthen employee morale, and increase profits
  • Earned several rapid promotions in my time at the office.

Education

Certified Medical Coder -

PMI
Antonio, TX
02.2020

Bachelor of Science - Healthcare Admin

Ashford University
San Diego, CA
11.2016

Associate of Science - Health Sciences

Community College of The Air Force
Montgomery, AL
10.2008

Bachelor of Science - Health Information Management

American Military University
Charles Town, WV

Skills

  • Technology:
  • AHLTA (EHR in the AF), ASIMS, CHCS, Microsoft Word, Excel, PowerPoint and Outlook), 45-50 WPM
  • Coding and Compliance:
  • HIPPA, Infection control, CPT/HCPCS, ICD-9, ICD-10
  • Claims processing
  • Medical billing and collections
  • Coding proficiency
  • Discrepancy reconciliation
  • Database updates
  • Customer relations
  • Account updating
  • ICD coding
  • Regulatory compliance
  • Detail orientation
  • Effective communication
  • Denial management
  • HIPAA compliance
  • Conflict resolution
  • Medical coding

Languages

  • Spanish (fluent)

    • Languages

    Spanish
    Native/ Bilingual

    Timeline

    BILLING SPECIALIST

    WellMed
    11.2019 - Current

    CREDENTIALING SPECIALIST/HR ASSISTANT

    Healthcare, Compliance
    05.2019 - 11.2019

    INDEPENDENT DUTY MEDICAL TECHNICIAN

    USAF
    07.2014 - 02.2018

    INDEPENDENT DUTY MEDICAL TECHNICIAN

    USAF
    07.2011 - 06.2014

    MEDICAL TECHNICIAN/IBT TECH/FAMILY PRACTICE MANAGER

    USAF
    10.2006 - 07.2011

    MEDICAL TECHNICIAN

    USAF
    10.2003 - 10.2006

    FRONT OFFICE/DENTAL ASSISTANT/OFFICE MANAGER

    DR GOLDSTEIN, DMD
    05.1999 - 01.2003

    Certified Medical Coder -

    PMI

    Bachelor of Science - Healthcare Admin

    Ashford University

    Associate of Science - Health Sciences

    Community College of The Air Force

    Bachelor of Science - Health Information Management

    American Military University

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