LAURA GARCIA
Corpus Christi
Summary
Detail-oriented Patient Representative Senior with Payment posting experience. 10 years of experience navigating insurance options in both long- and short-term care facilities. Adept at understanding and meeting Medicare requirements, resulting in significant success in maximizing reimbursements and optimizing revenue cycle management. Strong organizational skills and ability to handle multiple projects simultaneously with a high degree of accuracy. Valuable team player. Comprehensive background in managing medical records and health information systems. Proven ability to maintain confidentiality, while ensuring accuracy and compliance with regulatory standards. Strong skills in data management, electronic health records (EHR) software.
Detail-focused Medical Records and Health Information Technician known for high productivity and efficient task completion. Skilled in electronic health records management, patient data analysis, and ensuring compliance with healthcare regulations. Excel in organization, communication, and problem-solving to enhance operational efficiency and accuracy in managing sensitive information.
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Clinic Patient Representative Senior
Christus Trinity Clinic
Corpus Christi
07.2024 - Current
- Reduced insurance claim denials by diligently verifying patients' insurance coverage and eligibility.
- Collaborated with clinical staff to ensure seamless coordination of care, resulting in improved patient outcomes.
- Assisted patients in understanding their financial responsibilities, promoting transparency and trust between the facility and its clientele.
- Conducted regular audits of patient accounts to maintain accuracy, minimize errors, and prevent revenue loss due to incorrect billing practices.
- Maintained strict confidentiality of patient information in accordance with HIPAA regulations, protecting privacy rights at all times.
- Contributed to revenue growth by effectively managing payment collections from both insured and self-pay patients.
- Managed high call volumes while maintaining exceptional customer service standards for patients and healthcare providers alike.
- Resolved complex billing issues, ensuring accurate financial records and timely payments from patients and insurers.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Verified patient insurance eligibility and entered patient information into system.
- Interface with patients and families, physicians and staff.
- Update patient demographics/information in system.
- Verify insurance benefits, obtaining proper authorization from insurance carrier.
- Determine what funds to collect upon admission.
- Notify patients of monies due and document in billing system.
- Pulls payment information from Surgery Center bank account for Electronic Funds Transfers (EFTs) to post to PAS.
- Managed patient records and ensured compliance with privacy regulations.
- Processed medical documentation to maintain accurate patient information.
- Coordinated with healthcare providers to resolve discrepancies in records.
- Facilitated audits of medical records to ensure accuracy and completeness.
- Processed incoming medical records requests.
- Scanned incoming documentation.
- Organized patient charts, gathering medical histories, lab results and consents.
- Communicated with patients regarding requests for their medical records.
- Scanned and validated medical records for upload.
- Updated patient files with new medical information as needed.
- Scanned paper records into digital format.
- Processed and invoiced records requests from patients, providers and third parties.
- Responded to inquiries from patients, physicians and other healthcare providers regarding medical records.
Payment Posting Specialist/Insurance Coordinator
United Surgical Partners International
Corpus Christi
06.2023 - 06.2024
- Prepares batches daily.
- Posts all daily payments including, over the counter money, mail, credit card payments, and EFTs to PAS and verifies the system batch totals equal combined documents.
- Balance and Close all batches daily.
- Works rejections in Zirmed daily.
- Follow-up on current aging denials and payor issues to assist collector.
- Notifies supervisor of trends with insurance coverage, incorrect contract information, or any insurance and/or coding updates.
- Maintains working relationship with billing coordinator, collection specialist, and scheduler to ensure charges are correct at time of billing and to limit scheduling errors.
- Review & work incoming insurance and patient correspondence including refund requests.
- Ability to review medical documentation to justify medical necessity.
- Review patient balances to ensure accuracy and follow up with patients to obtain payments.
- Take incoming patient phone calls to resolve inquiries, billing issues, or outstanding balances.
- Review insurance payments and determine accuracy of reimbursement based on contracts, fee schedules or summary plan documents.
- Leverage knowledge of Medicare, state Medicaid, and local coverage determinations (LCD's) for claim resolution.
- Answer inbound calls in an effort to assist troubleshooting issues.
- Fulfilling customers request in quick response time.
- Managing priorities to meet customer needs efficiently and accurately using Frost Core Values; Integrity, Caring and Excellence.
Customer Service Representative
Frost Bank
06.2022 - 06.2023
- Customer Service.
- Telephone Customer Service.
- General Banking knowledge.
- Online Banking Experience.
- Proficient in Microsoft Computer Applications (Word, Excel, Access, PowerPoint, and Project).
- Telephone Etiquette.
- Sales.
Patient Access Rep
Driscoll Children's Hospital
09.2018 - 06.2022
- Review & work incoming insurance and patient correspondence including refund requests.
- Ability to review medical documentation to justify medical necessity.
- Review patient balances to ensure accuracy and follow up with patients to obtain payments.
- Take incoming patient phone calls to resolve inquiries, billing issues, or outstanding balances.
- Review insurance payments and determine accuracy of reimbursement based on contracts, fee schedules or summary plan documents.
- Leverage knowledge of Medicare, state Medicaid, and local coverage determinations (LCD's) for claim resolution.
Patient Access Specialist
TLC Complete Care Emergency
04.2017 - 09.2018
Front Office Coordinator
The Doctors' Center Urgent Care
03.2016 - 03.2017
Medical Office Specialist / Receptionist
01.2016 - 03.2016
Medical Office Specialist
09.2015 - 12.2015
Education
Diploma -
Brightwood College
Diploma -
Innovative Approaches To Education
Skills
- Insurance Verification
- Data entry proficiency
- Payment Collection
- Understanding EOB's
- Correspondence
- Word Processing
- Discrepancy Reconciliation
- HIPAA Compliance
- Payment reconciliation
- Medical Billing Expertise
- Claims Processing
- Patient account management
- Collections
- Accounts receivable management
- Medical coding knowledge
- Records organization and review
- Customer Service
- Team Collaboration
- Decision-Making
- Microsoft Office
- Payment Transactions
- Account Reconciliation
- Payment Processing
- Collections processing
- Records organization
Certification
Certified Insurance Coding Specialist, National Association of Health Professionals (NAHP)
Timeline
Clinic Patient Representative Senior
Christus Trinity Clinic
07.2024 - Current
Payment Posting Specialist/Insurance Coordinator
United Surgical Partners International
06.2023 - 06.2024
Customer Service Representative
Frost Bank
06.2022 - 06.2023
Patient Access Rep
Driscoll Children's Hospital
09.2018 - 06.2022
Patient Access Specialist
TLC Complete Care Emergency
04.2017 - 09.2018
Front Office Coordinator
The Doctors' Center Urgent Care
03.2016 - 03.2017
Medical Office Specialist / Receptionist
01.2016 - 03.2016
Medical Office Specialist
09.2015 - 12.2015
Diploma -
Brightwood College
Diploma -
Innovative Approaches To Education