Alicia Jeanette Reyes
Victorville,CA
Summary
Enterprising, results-oriented Collections Specialist, bringing 10+ years in accounts receivable and specializing in non-government collections. Adept at reaching out to account holders by phone, mail, and email. Skilled in resolving collection issues, adjusting accounts, and correcting discrepancies or short payments. Dynamic problem solver with first-rate skills in building relationships and resolving problems. Dedicated to exceeding goals and reducing company debt. Excellent communicator and closer with a solid record of success. Successful in applying recovery strategies and negotiating with account holders to cut outstanding debts and aged accounts. Strong researcher with top-notch follow-through and meticulous attention to detail. Offers professional challenges utilizing interpersonal skills, excellent time management, and problem-solving skills.
Overview
12
12
years of professional experience
1
1
Certification
Work History
AR Specialist II
Savista
11.2023 - Current
- Analyzed trends in payment patterns and customer behavior, identifying opportunities for process enhancements that would improve overall AR performance.
- Increased customer satisfaction levels by promptly addressing inquiries regarding billing issues or adjustments needed on their accounts.
- Coordinated with external collections agencies when necessary, ensuring seamless handoff of delinquent accounts while protecting company interests at all times..
Contract validation
Providence Health
10.2022 - Current
- Analyze contracts and calculating the expected reimbursement
- Assuring that insurance companies are reimbursing accordingly
- Submitting written appeals
- Submitting negotiation letters for non contracted payers
- Training on coming new employees
- Resolves any issues with coverage and escalates complicated issues to manager
- Work the essential queues to ensure all requests are resolved and errors corrected in a timely fashion
- Verifies patient demographics and insurance providers, updates information in systems, and documents
- Identifying the responsibility party for payment
- Utilizing Word, Excel, and Outlook as appropriate to aid in the completion of daily tasks
SENIOR COLLECTOR
USC
07.2021 - 10.2022
- Analyze and document high-dollar claims exceeding $7k
- Obtain authorization status and eligibility, meet deadlines, and work on special projects
- Generating and analyzing tracking reports collaboratively with management to evaluate trends
- Understand the explanation of benefits (EOB) and assigned patient liability, including secondary and tertiary responsibilities
- Maintain high call volume and meet the demands of busy and productive team members
- Monitor accounts for compliance with established payment plans and flagged non-compliances
- Process and paying claims directly with insurers require a basic understanding of percentages and basic math
CASE MANAGER II
Health Advocates
01.2021 - 07.2021
- Reviewed open and closed accounts to determine the status of submitted claims and investigated reasons for denials
- Contacting insurance companies about the status of submitted claims and investigating reasons for denials
- Preparing and submitting billing data and medical claims to insurance companies
- Worked as efficiently and productively in high-pressure situations is also an essential skill
- Managed support services and fostered communication among social workers, staff, and patients
- Collaborated with insurance companies, social workers, and case managers to develop and implement individualized care plans and document interactions and interventions
- Participated in weekly staff meetings, reviewing high dollar accounts, and seeking account resolutions
LEAD COLLECTOR
Verity Health System
03.2020 - 08.2020
- Monitored and evaluated associate performance; provided feedback for performance enhancement
- Extensive experience executing medical billing for commercial and managed care insurance
- Provided detailed responses to quality system issues and collection processes as needed
- Retrieved medical records, updated patient information in the computer system, documented the account's current status and tried to collect the debt
- Prepared spreadsheets, appeals, and letters following company policy
- Assigned and monitored work priorities to staff and plans, implemented, and met team goals and objectives
- Adhered to company confidentiality policy and met special project deadlines; worked closely with supervisors and management to identify issues and resolve them
SENIOR COLLECTOR
UCLA Medical Center
10.2017 - 03.2020
- Provided appropriate follow-up and documentation in the case of high-dollar accounts to maximize collection
- Assisted in training new members on company services, scripts, and collection strategies
- Worked with customers to create a debt repayment plan based on current financial conditions
- Advised clients on alternative options for debt repayment and entered client information and notes into a system that could be accessed and reviewed by other departments
- Located customers with overdue accounts and solicited payment in compliance with fair debt collection practices
- Processed debtor payments and updated accounts to reflect new balances
SENIOR COLLECTOR
Good Samaritan Hospital
04.2015 - 10.2017
- Submitted 45 claims per day, more than the daily quota
- Analyzed claim denials to determine appropriate action
- Performed claim follow-up on assigned accounts for claim denials and underpayments
- Listened to customers and negotiated solutions that met creditor and debtor needs
- Compiled and analyzed data for review by senior management of loan loss reports to measure portfolio performance
- Enforced scheduled collection campaigns and consistently achieved targeted recovery rates to prevent impending loss and increase profitability
- Maintained account demographics as needed
- Performed claim follow-up on assigned accounts.; responded to insurance requests
INSURANCE FOLLOW-UP REPRESENTATIVE
USCB - UC San Diego Medical center
07.2014 - 04.2015
- Adhered to compliance with FDCPA, FCRA, HIPAA, local, state, and federal collection laws
- Achieves a daily claim quota of 45 accounts
- Communicated professionally with colleagues, freelancers, and clients
- Reviewing accounts for appropriate contract reimbursement after analyzing claim denials
- Made written appeals for claim denials and underpayments; updated account information as needed
- Communicated effectively with customers about account changes, new products or services, and potential upgrades
INSURANCE FOLLOW-UP REPRESENTATIVE
USCB - Daughters of Charity
11.2012 - 07.2014
- Perform claim follow-up on assigned accounts
- Analyzed accounts for appropriate contract reimbursement
- Exceeded daily claims quota of 45 accounts per day
- Documented account actions based on payor resolution; analyzed denials of claims to determine appropriate actions
- Ensured workflow standards were followed and special projects were completed as assigned
- Increased efficiency and performance by monitoring team member productivity and providing feedback
Education
Medical Billing & Insurance Coding Course -
UEI College
07.2012
High School Diploma -
Compton High School
05.2011
Skills
- Persuasion Techniques
- Issue Investigation
- History Research
- Performance Improvements
- Codes Reviewing
- Accurate Payment Posting
- Aging Reports Analysis
- Analytical & Problem-solving Skills
- Decision-Making
- Attention to Detail
- Account Analysis
- Medical Collections
- Billing
- Hospital & Office Setting
- Customer Relationship Management
- Motivation
- Teamwork
- Critical & Reflective Thinking
- Time Management Skills
- Communication & Interpersonal Skills
Certification
- HIPAA Certification
- CPR Certified
Timeline
AR Specialist II
Savista
11.2023 - Current
Contract validation
Providence Health
10.2022 - Current
SENIOR COLLECTOR
USC
07.2021 - 10.2022
CASE MANAGER II
Health Advocates
01.2021 - 07.2021
LEAD COLLECTOR
Verity Health System
03.2020 - 08.2020
SENIOR COLLECTOR
UCLA Medical Center
10.2017 - 03.2020
SENIOR COLLECTOR
Good Samaritan Hospital
04.2015 - 10.2017
INSURANCE FOLLOW-UP REPRESENTATIVE
USCB - UC San Diego Medical center
07.2014 - 04.2015
INSURANCE FOLLOW-UP REPRESENTATIVE
USCB - Daughters of Charity
11.2012 - 07.2014
Medical Billing & Insurance Coding Course -
UEI College
High School Diploma -
Compton High School
- HIPAA Certification
- CPR Certified
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