April Ruiz-Castillo
Certified Billing And Coding Specialist
San Antonio
Summary
Experienced and knowledgeable Medical Biller and Medical Assistant with a strong understanding of coding and medical terminology. Skilled in efficiently managing accounts and handling records management tasks. Polished and hardworking performer consistently delivering accurate and reliable results. Team-oriented individual with exceptional decision-making skills, contributing to the overall success of the organization.
Overview
2025
2025
years of professional experience
4036
4036
years of post-secondary education
Work History
Medical Billing Coordinator
Mi Familia Home Health Services
3 2023 - Current
- Preforming appeals by analyzing aging reports and EOBs, drafting appeal letters, and reviewing medical records for medical necessity
- Making outbound calls payors for appeals and billing follow ups
- CMS-1500 billing forms
- Posting Payments into Wellsky EMR sysytem
- Provided administrative support to staff members, assisting with daily tasks as needed to promote productivity across the organization
- Coordinated with clinical teams to ensure proper documentation was received for accurate coding and claim submissions, reducing delays in reimbursements
- Medical Terminology
- Entered details into accounts and tracked payments
- HIPAA Compliance Understanding
- Communicated with insurance providers to resolve denied claims and resubmitted
- Generated monthly billing and posting reports for management review
- Submit and track all orders requiring physician signatures required for pre-claim billing and verifying all ICD-10 codes
- Improved billing accuracy by implementing stringent quality control measures and enhancing documentation processes
Office Assistant
Dr. Aneta Schnemeyer & Associates
10.2021 - 02.2022
- Scheduling, confirm, and reschedule appointments for six providers
- Handle prescription refill request and prior authorization request within a twenty-four hour time frame
- Verify patient eligibility, and benefits prior to patient appointments
- Collect patient balances, deductibles, co-pays
- Give explanations to patients regarding balances, and provide payment options and resolutions
- Enter demographics, referrals, and payments in EMR system
- Provide and maintain a professional customer service during stressful situations
Provider Services Representative
Healthcare Support Services
01.2021 - 10.2021
- Company Overview: Contract
- Answer inbound calls in a fast paced environment
- Assist providers with member eligibility and benefits regarding their insurance
- Route calls to correct departments when appropriate
- Complete monthly training regarding company's polices and updates
- Update provider demographics, and tax information
- Navigate providers through company website and promote resources
- Met customer call guidelines for service levels, handle time and productivity
- Add any documentation into Eclincials EMR
Patient Coordinator
Dr. Jessica Belz Plastic Surgery
07.2019 - 03.2020
- Arrange surgery quotes for patients, and discuss all financial options
- Schedule surgeries, including coordinating with labs, and physicians surgical assistant
- Monitor and respond to business social media pages and emails regarding questions and concerns
- Assist in creating all media advertising to promote office and product
- Record all money transactions in proper charts, and Excel spreadsheets
- Worked with patients and families to develop future plans and discuss care actions
- Explained upcoming treatment preparation, instructions and other facts to patients
- Reviewed medical charts and served as liaison between patient, doctor and hospital
- Researched and resolved billing discrepancies to enable accurate billing
- Worked effectively with medical payers such as Medicare, and commercial insurances to obtain timely and accurate payments
- Appealed claims according to Medicare guidelines providing all necessary documentation.
Medical Receptionist
South Texas Urogynecology
04.2017 - 07.2019
- Obtain and log referrals, and authorizations into Athena EMR system
- Answer multi-lines phone system, and routing calls to proper staff or departments
- Schedule, cancel or reschedule appointments
- Entering patient demographics and scanning insurance cards into EMR system
- Check patients in/out of office, and notify nurses or physicians of patients arrival
- Post payments to patients accounts, and make daily deposits
- Assist manager with other daily duties such as billing, and collections
- Managed master calendar and scheduled appointments for providers based on optimal patient loads and clinician availability
- Helped patients complete necessary medical forms and documentation
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options
Education
Certified Biller Coding Specialist -
National Healthcareer Association
San Antonio, TXCertificate-Medical Assistant -
Sanford Brown College
San Antonio, TX04-2011
Skills
Insurance Eligibility Verifications, for Commerical, Medicare, Medicare Advantage, and Medicaid
ICD-10 and CPT Knowledge
Claims Processing Proficiency
Medical Coding Expertise
Claim submission
Appeals Processing
Timeline
Office Assistant
Dr. Aneta Schnemeyer & Associates
10.2021 - 02.2022
Provider Services Representative
Healthcare Support Services
01.2021 - 10.2021
Patient Coordinator
Dr. Jessica Belz Plastic Surgery
07.2019 - 03.2020
Medical Receptionist
South Texas Urogynecology
04.2017 - 07.2019
Medical Billing Coordinator
Mi Familia Home Health Services
3 2023 - Current
Certified Biller Coding Specialist -
National Healthcareer Association
Certificate-Medical Assistant -
Sanford Brown College
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