Alejandro Velez
South El Monte,CA
Summary
Results-driven Medical Billing Supervisor with expertise in HIPAA compliance and revenue cycle management. Proven track record in optimizing workflows and mentoring teams to ensure accurate claims processing and timely payments.
Overview
2
2
years of professional experience
Work History
Medical Billing Supervisor
Open Arms Community Health and Service Center
Los Angeles, CA
08.2024 - Current
- Coordinated resolution process for outstanding enhanced care management and community support claims, ensuring timely payment and precision.
- Established streamlined workflows for medical billing division integrating up-to-date case management solutions for all licensed care managers.
- Processed over 15,000 claims for ECM and community supports, ensuring timely payment and accurate booking for company
- Oversee and mentor team of medical billers on updated insurance contracts and rates.
- portals and systems utilized included Availity, Office Ally, Health Net, Molina, Anthem, and Blue Shield of CA.
- Auditing bank accounts for company to ensure accurate fund distribution for ECM and community supports program.
- Managed daily submission of 80-100 claims ensuring coding accuracy and precise rate application.
- Developed a New System Database for the last year with Open Arms to start their very own database for their everyday ECM program.
- ensuring authorizations and insurances remained current for 1000+ member database for billing purposes and confirming each case is insured
- Oversaw claims denials by handling appeals and grievances to guarantee proper payment processing
Medical Biller and Coder
Billing Tower
Covina, CA
01.2024 - 07.2024
- Processed and submitted medical claims accurately using advanced billing software.
- Reviewed patient records for coding consistency and compliance with industry standards.
- Collaborated with healthcare providers to resolve claim discrepancies and ensure timely payments.
- Maintained up-to-date knowledge of coding regulations, payer policies, and reimbursement changes.
Education
Medical Billing And Coding Certification - Medical Billing And Coding
United Education Institute
West Covina, CA07-2024
Skills
- Team leadership and supervision
- ICD-10 knowledge
- Claims processing proficiency
- HIPAA compliance
- Conflict resolution strategies
- Revenue cycle management
- Workflow optimization techniques
- Commercial insurance policies
- Insurance claims processing
- Account management
- Records management
- Claim review
Timeline
Medical Billing Supervisor
Open Arms Community Health and Service Center
08.2024 - Current
Medical Biller and Coder
Billing Tower
01.2024 - 07.2024
Medical Billing And Coding Certification - Medical Billing And Coding
United Education Institute