Summary
Overview
Work History
Education
Skills
Timeline
Generic

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, Texas

College Coursework Completed in Nursing

San Antonio College (SAC)
San Antonio, Texas

Skills

  • 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)
Melissa De La Garza