SABELLA SIMEUS
San Antonio,TX
Summary
Dedicated healthcare operations professional with proven expertise in medical terminology, documentation accuracy, and high-quality patient and provider support.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Disability Claims Specialist
Leidos
02.2024 - Current
- Audited medical examination reports for disability determinations to ensure accuracy and compliance.
- Evaluated medical evidence for clarity, completeness, and claim alignment.
- Verified medical coding and terminology across all documentation.
- Coordinated with providers to obtain missing or corrected records.
- Requested additional exams when evidence did not meet requirements.
- Managed 60+ cases weekly with a 98% quality score.
- Collaborated with scheduling and operations to keep claims moving on time.
- Fully remote with consistent HIPAA compliance.
Lab Operation Manager
Community Health Centers of Central South Texas
01.2023 - 01.2024
- Performed 50+ venipunctures daily (capillary, IV, blood cultures) with strict adherence to infection-control and safety standards.
- Completed full vitals and diagnostic testing, including EKGs, BMI, BP, respirations, hemoglobin tests, and CBC panels.
- Entered and tracked patient data in EMR systems; monitored lab results, allergies, and vital signs.
- Managed patient flow, scheduling, supply ordering, billing tasks, and admissions.
- Improved patient satisfaction through fast issue resolution and clear communication.
- Leveraged data to enhance workflow efficiency and support operational decisions.
- Managed budgets, resources, and compliance to maintain high-quality lab operations.
- Trained staff, maintained documentation, and coordinated new program initiatives.
Medical Lab Technician
Worldwide Clinical Trials
08.2021 - 01.2023
- Performed full vitals and diagnostic testing; collected and processed blood specimens with 98%+ accuracy. Proficient in venipuncture, capillary draws, IV starts, and blood culture collection
- Collaborated with the R&D team to implement a new drug-screening process, reducing development costs by over 15%.
- Ensured strict adherence to infection-control and safety procedures during daily phlebotomy functions
- Trained new laboratory personnel to apply proper laboratory techniques and best practices.
Medical Insurance Customer Service Rep
The Results Company
01.2015 - 09.2018
- Prepare documentation for contracts, transactions, or regulatory compliance.
- Discuss account status or activity with customers or patrons.
- Execute sales or other financial transactions
- Verify HIPPA related information; Deliver service and support to health care providers and members; helping potential members evaluate and judge the merits of various plans to help them select the most appropriate type of coverage for their unique individual needs
- Provide and process and escalate information in response to claims, prior authorizations, and explanation of benefits; finding specific nature of the pre-authorization request, investigating policy coverage and fully explaining the findings to members and health care providers; provide letters confirming authorization for services and verifying coverage to a members and health care providers; Follow standard processes and procedures; identify and escalate priority issues.
Education
QTC Management
San Antonio, TX03-2024
Certificate of Completion - Medical Laboratory Science
Texas School Of Phlebotomy
San Antonio, TX06-2020
Bachelor of Science - Health Administration And Technology
Texas A&M University
Corpus Christi06.2027
High School Diploma -
Richard King High School
Corpus Christi, TXSkills
- Patient Care & Support
- Phlebotomy & Specimen Collection
- Medical Terminology
- EMR/EHR Systems
- Insurance Verification
- Medical Billing & Coding Basics
- Medical Records Management
- Documentation Review & Accuracy
- Quality Assurance & Compliance
- Time Management & Multitasking
- Customer Service & Communication
- Leadership & Workflow Coordination
Certification
- Phlebotomy Technician Certification
- ASCP
Timeline
Disability Claims Specialist
Leidos
02.2024 - Current
Lab Operation Manager
Community Health Centers of Central South Texas
01.2023 - 01.2024
Medical Lab Technician
Worldwide Clinical Trials
08.2021 - 01.2023
Medical Insurance Customer Service Rep
The Results Company
01.2015 - 09.2018
QTC Management
Certificate of Completion - Medical Laboratory Science
Texas School Of Phlebotomy
Bachelor of Science - Health Administration And Technology
Texas A&M University
High School Diploma -
Richard King High School