Selene Fernandez
Harlingen,TX
Summary
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
20
20
years of professional experience
Work History
MES II
HHSC
Harlingen, TX
12.2023 - 02.2026
- Conducted client interviews to gather information and verify eligibility for complex Medicaid programs.
Reviewed and maintained eligibility records, including redeterminations for ongoing benefits.
Interpreted and applied federal and state policies across TANF, SNAP, and Medicaid programs.
Explained program benefits and requirements to clients, providers, and stakeholders effectively.
Documented information accurately in automated systems (Tiers/EWMS) to ensure compliance. - Completed day-to-day duties accurately and efficiently.
- Contributed innovative ideas and solutions to enhance team performance and outcomes.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
- Evaluated client eligibility for various assistance programs and benefits.
- Processed applications using online systems and maintained accurate records.
- Reviewed case files for compliance with federal and state regulations.
- Maintained comprehensive knowledge of program regulations, policies, and procedures.
Surgery Scheduling Coordinator
Tenet Health-Valley Baptist Medical Center
Harlingen, TX
12.2016 - 11.2023
- Obtained accurate information to complete registration for day surgery, outpatient radiology, cardiology, endoscopy, ambulatory infusion, and admissions including scheduling.
- Verified insurance information and secured payment of patients' financial liability, performed collection efforts, and referred patients to apply for assistance.
- Obtained authorization from insurers and healthcare providers to complete all pre-certification requirements.
- Verified that orders were complete and matched the scheduled procedure, indexed, and exported physicians' orders to the correct account number.
- Facilitated communication with physician offices and ensured proper corrections were made to orders to meet billing requirements.
- Scheduled surgical procedures and managed physician calendars efficiently.
- Communicated effectively with patients regarding pre-operative instructions and scheduling.
- Facilitated communication between departments to streamline surgical workflows.
- Provided support to surgeons by preparing documents needed for surgeries, such as consent forms and discharge instructions.
- Facilitated communication between surgeons, nurses, technicians and other healthcare professionals involved in the care of patients undergoing surgery.
Billing Specialist
Grace Center Adult Day Care
02.2016 - 08.2016
- Completed billing for 3 different sites and posted all incoming insurance payments to ensure accurate financial records.
- Verified insurance and obtained authorizations while managing multiple phone lines and setting driver routes to streamline patient attendance.
- Added new patient demographics to establish comprehensive patient charts for better record-keeping.
- Maintained accurate records of collections, adjustments and denials in the system.
- Verified insurance coverage and identified third-party payers for billing purposes.
- Monitored accounts receivable activity to ensure timely payment of invoices.
Clinical Requirement for TSTC/Billing Clerk
Valley Children's Clinic
05.2015 - 07.2015
- Conducted insurance verification, maintained medical records, and managed document processing in patient portal.
- Processed insurance claims and identified discrepancies in patient charts.
- Facilitated patient check-in and coordinated appointment scheduling.
Bilingual Inbound Customer Service Representative
Advanced Call Center Technology
Harlingen, TX
11.2005 - 05.2009
- Assisted customers with checking, savings, and CD account inquiries at Bank of America, ensuring timely resolution of issues.
- Reviewed account activity to resolve blocked accounts and directed calls to appropriate departments for further assistance.
- Collaborated with fraud prevention team to address security issues.
Education
Certificate of Completion - MEDICAL INFORMATION TRANSCRIPTIONIST
Texas State Technical College
Harlingen, TX08-2015
General Equivalency Diploma -
Texas State Technical College
Harlingen, TX08-2012
Skills
- Patient Access
- Medical coding
- ICD-9-CM
- 3M Encoder
- Cerner
- EWMS
- TIERS
- State Portal
- CAPPS
- SAVE
- Spring Charts
- Learning Management Systems
- CMS Insurance Forms
- Office 365
- Medical office management
- Bilingual Spanish/English
Timeline
MES II
HHSC
12.2023 - 02.2026
Surgery Scheduling Coordinator
Tenet Health-Valley Baptist Medical Center
12.2016 - 11.2023
Billing Specialist
Grace Center Adult Day Care
02.2016 - 08.2016
Clinical Requirement for TSTC/Billing Clerk
Valley Children's Clinic
05.2015 - 07.2015
Bilingual Inbound Customer Service Representative
Advanced Call Center Technology
11.2005 - 05.2009
Certificate of Completion - MEDICAL INFORMATION TRANSCRIPTIONIST
Texas State Technical College
General Equivalency Diploma -
Texas State Technical College