Experienced healthcare professional with 15+ years in medical office administration, focusing on medical billing/insurance, patient registration, scheduling, and medical records management. Proficient in identifying insurance plans (PPO, POS, HMO) and knowledgeable in medical terminology, CPT codes, and EMR systems. Expertise in healthcare protocols, HIPAA, and EMTALA regulations for ensuring compliance and providing quality patient care.
Overview
13
13
years of professional experience
Work History
Scheduling Coordinator/Patient Access Rep.
Texas Children's Hospital
05.2021 - 02.2025
Conducted registration and admission processes for inpatients and outpatients.
Secures necessary signatures for release of information and consent to treat.
Ensured financial stability of the facility by collecting patient liabilities.
Coordinated appointments for Behavioral Health and Specialty Clinics at various locations.
Documented calls and maintained accurate patient records in EMR systems
Verified and updated patient demographic and insurance data
Handled scheduling for 100+ patients daily, optimizing appointment flow and minimizing wait times
Collaborated with medical staff to prioritize urgent needs and special scheduling requests
Provided high-level customer service with empathy and professionalism
Ensured HIPAA compliance and obtained authorizations for procedures
Scheduled follow-up visits based on treatment plans
Identified alternative resources to secure financial reimbursement.
Customer Service Representative
Blue Cross Blue Shield
02.2015 - 02.2021
Explained medical benefits to more than 100 patients daily.
Handled provider and member inquiries, verified insurance, processed appeals, and claims
De-escalated calls and addressed member complaints with professionalism
Reviewed and submitted medical documentation using ICD-10 and CPT codes
Followed up on unpaid/denied claims and collaborated with providers for documentation
Trained new hires on billing systems and procedures
Explained insurance benefits and claim statuses to patients and providers
Medical Records Clerk
MHMRA | The Harris Center for Mental Health and IDD
06.2012 - 01.2015
Prepares, updates, and maintains a medical record for each patient, ensuring the accuracy of information.
Maintains an appointment system for patients and clinical staff, where applicable.
Organized and uploaded lab, radiology, and additional reports to correct sections of electronic medical records promptly.
Routes clinical reports to appropriate clinic staff within prescribed timeline.
Reviews all documentation for completeness and routes incomplete documents to the appropriate provider for correction prior to placing/scanning in the medical records
Organized and filed records by standard protocols and filing systems
Reviewed scanned documents for quality, accuracy, and proper identification
Handled incoming requests via mail, fax, and walk-ins regarding patient information
Validated authorization forms and processed medical records in compliance with HIPAA
Managed physician schedules and prepared patient charts
Input legal, medical, and financial documents into patient charts
Performed general office duties: faxing, emailing, filing, and mailing
Skills
Medical Billing & Insurance Verification
EMR Systems (Electronic Medical Records)
HIPAA Compliance
Customer Service & Conflict Resolution
Medical Terminology
Time Management & Organizational Skills
Managed Care Knowledge
Medical Records Management
Timeline
Scheduling Coordinator/Patient Access Rep.
Texas Children's Hospital
05.2021 - 02.2025
Customer Service Representative
Blue Cross Blue Shield
02.2015 - 02.2021
Medical Records Clerk
MHMRA | The Harris Center for Mental Health and IDD
Technical Coordinator- Hematology and Urinalysis at Texas Children's Hospital North AustinTechnical Coordinator- Hematology and Urinalysis at Texas Children's Hospital North Austin