GLORIA LOPEZ
Worcester
Summary
Healthcare professional prepared to lead medical billing departments with focus on accuracy and regulatory compliance. Extensive experience in optimizing billing workflows and improving revenue cycles. Known for fostering collaborative environments and adapting to evolving industry standards with ease.
Overview
13
13
years of professional experience
Work History
Medical Billing Director
Webster Home Care
05.2024 - Current
- Spearheaded efforts to adopt electronic health record systems, streamlining data management and improving overall efficiency.
- Championed technological advancements within the organization by staying current with industry trends related to billing and coding practices.
- Managed budgets for the medical billing department, ensuring cost-effective allocation of resources without compromising service levels or accuracy standards.
- Reduced billing errors by regularly reviewing team performance and providing targeted training to address knowledge gaps.
- Developed strong relationships with insurance companies to negotiate favorable terms for prompt reimbursements.
- Ensured timely submission of accurate claims by establishing clear expectations and deadlines for the team.
Patient access- Registration ED room
UMass Memorial Medical Center
01.2022 - Current
- Obtains and enters the computer-based patient registration/scheduling system, demographic, insurance, and other related patient information
- Obtains and verifies patient insurance coverage and follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and physician referrals for treatment are obtained prior to patient visits
- Follows up to correct discrepancies as required
- Provides patients with standard information regarding their personal preparation for scheduled procedures
- Transcription of paper orders when applicable
- Assesses patients’ financial needs and directs accordingly to financial counseling and refers to appropriate person or area
- Provides a variety of related clerical duties, such as retrieving medical and other records, faxing, collating, typing, transcribing, taking and relaying messages, etc
- Maintains accurate and timely records, logs, charges, files, and related information as required
- Collection of patient liabilities including deductibles, copays, coinsurances, self-payment, cosmetic procedure payments, and patient balances as appropriate, prior to or on the date of service
- Obtains patient and witness signatures for all paperwork, including but not limited to Consent to Treat, HIPAA, Privacy, Medicare Rights, Important Message for Medicare, Patient Rights, etc
- Reviews work queues to ensure accurate and timely billing
- Monitors and maintains Patient Access and Revenue Cycle Work queues
- Maintains scheduling and/or registration accuracy rate of 97% or above
- Customer service skills both verbal and written; with a variety of internal and external customers
- Use of computer skills that include use of Windows and the ability to navigate
- Ability to work in a high volume, team-oriented environment
- English and Spanish speaking, reading, and writing skills
- Proficient data-entry skills with attention to detail
Office Manager
Webster Home Care
01.2012 - Current
- Point person for maintenance, mailing, shipping, supplies, equipment, bills, and errands
- Partner with HR to maintain office policies as necessary
- Responsible for managing office services by ensuring office operations and procedures are organized, correspondences are controlled, filing systems are designed, supply requisitions are reviewed and approved, and that clerical functions are properly assigned and monitored
- Ensure office efficiency is maintained by carrying out planning and execution of equipment procurement, layouts, and office systems
- Design and implement filing systems
- Ensure filing systems are maintained and current
- Establish and monitor procedures for record-keeping
- Ensure security, integrity, and confidentiality of data
- Monitor and maintain office supplies inventory
- Handle customer inquiries and complaints
- Collect, calculate, and enter data, thereby maintaining payroll information
- Ensure differences in payroll calculations are resolved by gathering and evaluating relevant information
- Responsible for providing information relating to payroll to management and the employees as may be requested, as well as answering questions from them
- Ensure company and staff information is kept confidential to protect payroll operations and win the confidence of employees
- Facilitate effective communication between two parties that do not speak a similar language by converting one spoken or written language to another
- Interpreting in corresponding language concepts and ideas when needed
- Rendering sight translations of documents and other written materials
- May be asked to perform other duties that are important to the smooth running of the company
- Assisted the manager with overseeing all office operations
- Trained and mentored new office staff
Education
Medical Terminology -
Quinsigamond Community College
Worcester, MA01.2023
Medical interpreter -
LANGUAGE LINK INTERPRETER SERVICES
Worcester, MA01.2021
Dental Assistant -
NEW ENGLAND DENTAL ASSISTANT SCHOOL
Worcester, MA01.2013
High School Diploma -
NORTH HIGH SCHOOL
Worcester, MA01.2010
Skills
- Customer Service
- Documentation
- Communication
- Listening
Languages
Spanish
Native or Bilingual
Timeline
Medical Billing Director
Webster Home Care
05.2024 - Current
Patient access- Registration ED room
UMass Memorial Medical Center
01.2022 - Current
Office Manager
Webster Home Care
01.2012 - Current
Medical interpreter -
LANGUAGE LINK INTERPRETER SERVICES
Dental Assistant -
NEW ENGLAND DENTAL ASSISTANT SCHOOL
High School Diploma -
NORTH HIGH SCHOOL
Medical Terminology -
Quinsigamond Community College
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