Melissa De La Garza
San Antonio,Texas
Summary
Experienced and bilingual professional with over 10 years of proven expertise in office management, coding, and teamwork. Demonstrates the ability to resolve complex issues while consistently delivering exceptional service to patients. Cultivates strong relationships with leadership, fostering seamless collaboration across departments. Recognized for quickly identifying problems and implementing effective solutions. Utilizes excellent communication skills in both English and Spanish to successfully accomplish objectives.
Overview
16
16
years of professional experience
Work History
Patient Benefits Representative (Insurance Verifier)
Texas Oncology
01.2022 - Current
- Served as the primary liaison between the insurance agencies, patients, and medical providers
- Communicated with80-100 patients per day, providing insurance estimates, completing forms, and explaining benefits
- Completed up to100 fee slips daily, for three offices, working within strict time constraints
- Collaborated with doctors, hospitals, and government agencies to refer patients to financial assistance programs and find alternative solutions
- Audited and corrected financial statements from the billing department, revising up to50% of the statements, and ensuring it accurately reflected the costs
Clinical Documentation Specialist
3M (Formally KCI)
01.2021 - 01.2022
- Worked remotely to collect patient data while navigating organizational and procedural changes
- Assessed up to30 clients a day in a virtual setting, and gathered data on wound measurements to inform treatment plans and provide effective care
- Collaborated with home health care agencies to acquire accurate data
- Prioritized tasks after reviewing a high volume of incoming faxes, emails, and phone calls
Insurance Verifier
Dermatology San Antonio
01.2019 - 01.2021
- Consistently provided high-quality levels of service while working in-person and remotely
- Verified insurance benefits, including completing rebilling, claims, and appeals for patients, to maximum benefit allowance
Insurance Verifier and Hospital Registrar
Nix Health
01.2018 - 01.2019
- Gained knowledge of insurance verification and financial duties until the hospital’s closure
- Verified health insurance policies and initiated preauthorizations for all major commercial carriers and government healthcare agencies
- Performed electronic remits, denial/rejections, and or acceptance reports
- Supported other departments by cross-training as a Registrar, to improve patient care
Research Assistant and Patient Coordinator
Urology San Antonio
01.2009 - 01.2018
- Completed a breadth of duties for a growing practice while helping patients navigate treatment
- Promoted from Patient Coordinator to Research Assistant after demonstrating proficiency in administrative duties and patient care
- Performed lab testing and monitored patients involved in case studies, utilizing knowledge of medical equipment, and collaborating compassionately with patients
- Obtained, entered, and verified patient information, ensuring changes were communicated to the correct parties
- Coordinated as primary clinic contact for patient questions and collaborated with necessary departments to resolve discrepancies
- Assisted in all ranges of communication, either of clinical, or administrative nature (coordinating clinical calls with the physician)
- Coordinated with physicians/surgeons and their schedules
Education
Medical Coding and Billing
The College of Health Care Professions
San Antonio, TexasCollege Coursework Completed in Nursing
San Antonio College (SAC)
San Antonio, TexasSkills
- ICD-10, HCPCS, and CPT Coding
- Bilingual (English/Spanish)
- Medical Billing and Coding
- Medicare and Medicaid
- HIPPA & OSHA Compliance
- Scheduling and Referrals
- Software Programs: Med ISOFT, Medical Manager, eClinicalWorks, Next Gen, Athena, Mosaic, and Ability
Timeline
Patient Benefits Representative (Insurance Verifier)
Texas Oncology
01.2022 - Current
Clinical Documentation Specialist
3M (Formally KCI)
01.2021 - 01.2022
Insurance Verifier
Dermatology San Antonio
01.2019 - 01.2021
Insurance Verifier and Hospital Registrar
Nix Health
01.2018 - 01.2019
Research Assistant and Patient Coordinator
Urology San Antonio
01.2009 - 01.2018
Medical Coding and Billing
The College of Health Care Professions
College Coursework Completed in Nursing
San Antonio College (SAC)
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