Judith Barrera
San Antonio,Texas
Summary
Proven track record in enhancing operational efficiency and customer satisfaction at Centene, Superior Health Services, through expert eligibility determination and exceptional problem-solving abilities. Bilingual professional adept at streamlining processes and significantly improving billing accuracy. Achieved consistent program objectives and service consistency, demonstrating superior time management and customer service skills. Knowledge of HIPAA regulations, medical and insurance terminologies.
Overview
21
21
years of professional experience
Work History
Referral Coordinator
Methodist Healthcare
San Antonio, TX
08.2024 - Current
- Coordinated patient referrals to specialists, ensuring timely access to care.
- Streamlined referral processes, enhancing communication between providers and patients.
- Managed appointment scheduling using electronic health record systems for efficiency.
- Collaborated with healthcare teams to resolve referral-related issues promptly.
- Trained new staff on referral protocols and system usage for consistency in operations.
- Analyzed referral patterns to identify areas for process improvement and optimization.
- Implemented tracking systems for referrals, improving accountability and follow-up procedures.
- Responded to patient inquiries to offer timely updates regarding referral status.
Program Coordinator
Centene, Superior Health Services
San Antonio, TX
01.2012 - 12.2023
- Developed and maintained relationships with external partners to facilitate program operations.
- Collaborated with other program coordinators to achieve consistency in program objectives and services.
- Multi-tasked to meet end of day deadlines.
- Researched and obtained missing information for claims to be processed.
- Daily phone calls to case managers at facilities to obtain information or problem solve discrepancies.
- Approved authorizations and approval letters faxed to facility and provider.
- Daily use of TruCare, Amysis, Filenet and CPSI.
Insurance Verification Specialist
Nix Hospital
San Antonio, TX
05.2010 - 01.2012
- Enhanced claim processing efficiency by verifying insurance coverage and obtaining pre-authorizations for procedures.
- Reduced errors in billing by accurately maintaining patient records with updated insurance information.
- Improved communication between medical staff and patients by explaining insurance benefits and financial responsibilities.
- Streamlined workflow for medical providers by obtaining necessary referrals and authorizations for services.
- Expedited patient registration process by efficiently validating eligibility for various insurance plans.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
Billing Clerk
Iraan General Hospital
Iraan, TX
09.2004 - 03.2010
- Improved billing accuracy by diligently reviewing invoices and reconciling discrepancies.
- Enhanced client satisfaction by promptly responding to inquiries and resolving billing issues professionally.
- Expedited payment collection by consistently following up on overdue accounts and sending payment reminders.
- Reconciled cash received with payments recorded in billing system and reported discrepancies.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
- Coding and billing inpatient/outpatient claims for Critical Access Hospital.
- Collaborated with insurance representatives to expedite claim approvals, ensuring timely reimbursements for clients.
Education
High School Diploma -
Iraan High School
Iraan, TX1998
Skills
- Problem-solving abilities
- Customer service experience
- Patient scheduling
- Medical terminology
- Insurance verification
- Time management
- Microsoft Office- Word, Excel, Outlook, OneDrive Teams
- EMR systems- Meditech, TeleResults, CPSI, TruCare, Amysis
- Citrix Workspace
- Bilingual- English/Spanish
Languages
Spanish
Full Professional
Timeline
Referral Coordinator
Methodist Healthcare
08.2024 - Current
Program Coordinator
Centene, Superior Health Services
01.2012 - 12.2023
Insurance Verification Specialist
Nix Hospital
05.2010 - 01.2012
Billing Clerk
Iraan General Hospital
09.2004 - 03.2010
High School Diploma -
Iraan High School