Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Stephanie Diaz

Fort Worth,TX

Summary

Medical Billing Specialist with 6+ years of experience specializing in accurate CMS-1500 and UB-04 claim submission and insurance verification across diverse healthcare settings. Proficient in reducing denials through payer compliance, documentation review, and workflow optimization.

Overview

9
9
years of professional experience

Work History

Prior Authorization Specialist

Medix Staffing Solutions Inc.
01.2025 - 03.2025
  • Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
  • Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
  • Verified eligibility and compliance with authorization requirements for service providers.
  • Analyzed medical records and other documents to determine approval of requests for authorization.
  • Reached out to insurance carriers to obtain prior authorization for testing and procedures.
  • Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.

Medical Billing Specialist

Warthan Dermatology Center
04.2024 - 12.2024
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Posted and adjusted payments from insurance companies.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
  • Located errors and promptly refiled rejected claims.
  • Identified and resolved patient billing and payment issues.
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.

A/R Representative

Clinical Health Solutions
10.2023 - 04.2024
  • Ensured accurate coding and billing practices, resulting in reduced claim rejections and faster reimbursements.
  • Handled institutional and professional claim formats (UB-04 & CMS-1500), driving down A/R days
  • Reviewed patient records, identified medical codes, and created invoices for billing purposes.
  • Provided exceptional customer service while addressing patient inquiries regarding billing issues or concerns.
  • Reduced account receivables aging through diligent follow-up on outstanding claims and prompt resolution of denials.

Patient Access Coordinator

Fort Worth Perinatal Associates
08.2020 - 09.2023
  • Maintained strict adherence to HIPAA regulations while managing confidential patient information throughout various stages of care.
  • Managed high volumes of inbound calls while addressing scheduling requests, appointment confirmations, prescription refills, and general inquiries professionally.
  • Increased efficiency of daily operations by implementing electronic health record system for accurate data management.
  • Reduced errors in billing processes by meticulously reviewing and verifying patient demographics and insurance information.
  • Enhanced communication between departments by regularly updating patient information and coordinating schedules.

Medical Billing Assistant

Mednax Health Solutions
09.2017 - 01.2020
  • Ensured timely claim submission and follow-up, reducing denials and accelerating reimbursement
  • Processed high volumes of CMS-1500 and UB-04 claims with accuracy and attention to payer-specific requirements
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Assured accurate charge capture by working closely with clinical staff to verify services provided before submitting claims.
  • Maximized reimbursement opportunities by staying current on industry trends and new billing procedures.
  • Enhanced revenue collection rates with timely follow-ups on outstanding claims and appeals.

Patient Coordinator

Ophthalmology Associates
05.2016 - 09.2017
  • Increased efficiency of the front office operations through effective multitasking, attention to detail, and organization skills.
  • Provided excellent customer service to all patients, addressing concerns and answering questions promptly and professionally.
  • Handled sensitive situations with empathy when dealing with distressed patients or those facing serious health challenges.
  • Maintained up-to-date knowledge on insurance policies, medical terminology, and clinic protocols in order to provide accurate information and assistance to patients.
  • Coordinated referrals to specialists as needed, following up with patients to confirm appointments and provide necessary information.
  • Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.

Education

North Crowley High

Health Administration

Everest College

Skills

    CMS-1500 & UB-04 Claim Processing

    Revenue Cycle Management (RCM)

    Insurance Verification & Pre-Authorizations

    Accounts Receivable (A/R) Management

    EMR Systems (Epic Resolute, etc)

    Payer Policy Analysis & Remittance Review

Languages

Spanish
Native or Bilingual

Timeline

Prior Authorization Specialist

Medix Staffing Solutions Inc.
01.2025 - 03.2025

Medical Billing Specialist

Warthan Dermatology Center
04.2024 - 12.2024

A/R Representative

Clinical Health Solutions
10.2023 - 04.2024

Patient Access Coordinator

Fort Worth Perinatal Associates
08.2020 - 09.2023

Medical Billing Assistant

Mednax Health Solutions
09.2017 - 01.2020

Patient Coordinator

Ophthalmology Associates
05.2016 - 09.2017

North Crowley High

Health Administration

Everest College

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