Stephanie Gamez
Tucson,Az
Summary
Highly skilled and accomplished business-minded medical professional with a proven track record in effectively managing diverse patient accounts. Possessing over 10 years of experience in processing financial forms and obtaining referrals and other health documentation, adept at navigating complex administrative processes. Recognized for maintaining a calm and poised demeanor in all situations, consistently delivering exceptional results while prioritizing patient care and satisfaction.
Overview
8
8
years of professional experience
Work History
Financial Counselor
Tucson Medical Center
01.2024 - Current
- Acted as an advocate for patients during billing negotiations, working towards mutually beneficial agreements that facilitated debt resolution.
- Liaised between patient, doctor and insurance provider to smooth claims processes.
- Proven ability to develop and implement creative solutions to complex problems.
- Gained extensive knowledge in data entry, analysis and reporting.
- Worked effectively in fast-paced environments.
- Self-motivated, with a strong sense of personal responsibility.
- Passionate about learning and committed to continual improvement.
- Developed and maintained courteous and effective working relationships.
- Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
- Skilled at working independently and collaboratively in a team environment.
- Demonstrated a high level of initiative and creativity while tackling difficult tasks.
- Completed paperwork, recognizing discrepancies and promptly addressing for resolutions.
- Worked with patient to develop personal recommendations for resolutions of financial circumstances, including reducing debt.
Insurance Verification Specialist
Tucson Medical Center
01.2024 - Current
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Updated patient records with accurate, current insurance policy information.
- Achieved insurance pre-authorizations to enable timely patient procedures.
- Trained new staff on current, correct insurance verification procedures.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Conducted patient intake interviews, recording and documenting relevant information.
- Completed administrative patient intakes with case histories, insurance information and mandated forms.
- Tracked referral submission during facilitation of prior authorization issuance.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Verified eligibility and compliance with authorization requirements for service providers.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Researched denied claims and contacted insurance companies to resolve these issues.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Developed and maintained productive working relationships with healthcare providers.
Medical Scheduler
Camp Lowell Cardiology
08.2021 - 01.2024
- Scheduled patients appointments and placed reminder calls to deliver exceptional customer experience.
- Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing.
- Enhanced office productivity by handling high volume of callers per day.
- Audited customer files to verify medical necessity and satisfaction of coverage criteria.
- Obtained necessary signatures on information release forms to obtain medical and treatment records from other service providers.
- Processed over 100 medical records requests from outside providers according to facility, state and federal law.
- Communicated effectively with staff, patients and insurance companies by email and telephone.
- Input data into computer programs and filing systems.
- Posted billings to medical insurance providers.
- Compiled, abstracted and coded patient data using classification manuals and standard systems.
- Reviewed over 45 pages of patient records, identified medical codes and created invoices for billing purposes.
Patient Financial Services Representative
Banner University Medical Center Tucson
06.2020 - 09.2021
- Coordinate communication between patients, family members, medical staff, administrative staff, or regulatory agencies.
- Refer patients to appropriate health care services or resources.
- Explain policies, procedures, or services to patients using medical or administrative knowledge.
- Established and report data on topics such as patient encounters and inter-institutional problems, making recommendations for change when appropriate.
- Analyze patients' abilities to pay to determine charges on sliding scale.
- Operate telephone switchboard to answer, screen, or forward calls, providing information, taking messages, or scheduling appointments.
- Transmit information or documents to customers, using computer, mail, or facsimile machine.
- Hear and resolve complaints from customers or public
- File and maintain records.
- Provide information about establishment, such as location of departments or offices, employees within organization, or services provided.
- Collect, sort, distribute, or prepare mail, messages, or courier deliveries.
- Receive payment and record receipts for services.
- Schedule appointments and maintain and update appointment calendars.
- Operate office equipment, such as voice mail messaging systems, and use word processing, spreadsheet, or other software applications to prepare reports, invoices, financial statements, letters, case histories, or medical records.
- Complete insurance or other claim forms.
- Receive and route messages or documents, such as laboratory results, to appropriate staff.
- Compile and record medical charts, reports, or correspondence, using typewriter or personal computer.
- Maintain medical records, technical library, or correspondence files.
- Transmit correspondence or medical records by mail, e-mail, or fax.
- Perform bookkeeping duties, such as credits or collections, preparing and sending over 456 financial statements or bills, and keeping financial records.
- Arrange hospital admissions for over 90 patients daily
Patient Care Coordinator
Alvernon Optical Inc.
11.2018 - 03.2020
- Worked with patients and families to develop future plans and discuss care actions.
- Acted as main point of contact for patients, doctors and hospital staff by closely reviewing medical charts and maintaining high levels of communication.
- Completed documentation of care, hospital actions and patient activities.
- Upheld confidentiality requirements and regulatory compliance guidelines in all areas.
- Built strong referral network by developing strategic relationships with general practitioners and internists.
- Educated patients by explaining preparation instructions for upcoming procedures and tests.
- Reviewed medical charts and served as liaison between patient, doctor and hospital.
- Managed prescriptions by sending electronic requests for new medications and refills.
- Obtained necessary signatures on information release forms to obtain medical and treatment records from other service providers.
- Processed over 56 medical records requests from outside providers according to facility, state and federal law.
- Maintained historical reference by abstracting and coding clinical data such as diseases, operations, procedures and therapies with standard classification systems.
- Reviewed charts and flagged incomplete or inaccurate information.
Receptionist
National Eye And Ear
02.2017 - 02.2018
- Answered and quickly redirected up to 60 calls per Hour
- Acted as first point of contact and set appointments for prospective clients.
- Offered appointment information updates and rescheduling to guests.
- Greeted customers and visitors in-person and via telephone calls.
- Greeted arriving members professionally by first name.
- Corresponded with clients through email, telephone or postal mail.
- Welcomed all customers with friendly greeting, answered general questions, gathered nature of visit and directed to specific offices.
- Handled complaints and questions, and re-directed calls to other team members as appropriate.
Education
No Degree - Medical Informatics
University of Phoenix
Tempe, AZSome College (No Degree) - Criminal Justice
University of Phoenix
2019
High School Diploma -
Amphitheater High School
05.2011
Skills
- Healthcare operations
- Scheduling
- Regulatory Compliance
- Quality Standards and Protocols
- Office Administration
- Patient Registration
- HIPAA Compliance
- Administrative and Office Support
- Insurance Verification
- Patient Records Management
Languages
Spanish
Professional Working
Timeline
Financial Counselor
Tucson Medical Center
01.2024 - Current
Insurance Verification Specialist
Tucson Medical Center
01.2024 - Current
Medical Scheduler
Camp Lowell Cardiology
08.2021 - 01.2024
Patient Financial Services Representative
Banner University Medical Center Tucson
06.2020 - 09.2021
Patient Care Coordinator
Alvernon Optical Inc.
11.2018 - 03.2020
Receptionist
National Eye And Ear
02.2017 - 02.2018
High School Diploma -
Amphitheater High School
No Degree - Medical Informatics
University of Phoenix
Some College (No Degree) - Criminal Justice
University of Phoenix
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