Bianca Aguayo
Cerritos,CA
Summary
Skilled professional ready to excel in a leadership role in Revenue Cycle with a focus on results-driven performance. Proven ability to streamline operations and foster team collaboration to achieve organizational goals. Known for reliability and adaptability in meeting changing demands while maintaining high standards.
Overview
13
13
years of professional experience
Work History
Supervisor Insurance Services
R1 RCM
04.2019 - Current
- Demonstrated advanced proficiency in Epic Hyperspace, Cash Pro, SSI, OnBase, and Office Ally to support efficient revenue cycle operations.
- Oversee daily functions of the revenue cycle, including manual payment posting, remittance processing, PB remittance runs, and resolution of cash management discrepancies.
- Monitored and reconciled daily and month-end payments, ensuring accuracy in insurance and patient transactions, credits, and refunds.
- Investigated and resolved complex payment issues, including missing payments, unbalanced batches, and credit escalation cases.
- Directed pre-billing error resolution and claim edit management within Epic to ensure clean claim submission and timely reimbursement.
- Supervised staff across multiple revenue cycle functions, establishing strategic work plans and performance benchmarks.
- Recruited, hired, trained, and mentored team members, fostering professional development and maintaining high retention rates.
- Developed and implemented policies, procedures, and workflows to streamline operations and enhance compliance.
- Managed billing, collections, and payment posting for PPO, HMO, Medicare, and Medi-Cal payers.
- Led initiatives to optimize patient data management and improve overall financial performance.
Sr. Collection Rep
St Joseph Heritage/ Medirevv
04.2016 - 04.2019
- Managed and analyzed outstanding insurance collections and full accounts receivable (AR) reports for both primary and secondary payers, ensuring timely follow-up and resolution
- Investigated claim denials and collaborated with billing and coding teams to initiate and support appeals, driving successful reimbursement outcomes.
- Led and contributed to AR-focused special projects, streamlining processes and improving overall collection efficiency
A/R specialist
Conifer Health
03.2015 - 11.2015
- Managed aged insurance accounts, identifying and resolving outstanding balances through strategic follow-up and claim resubmission.
- Analyzed denial trends and individual claim denials to determine root causes and initiate appropriate appeals or corrections.
- Submitted and tracked corrected claims and appeals to ensure timely reimbursement from commercial and government payers.
- Conducted detailed reviews of UB claims and collaborated on AR special projects to enhance operational efficiency.
- Utilized systems including ACE, OnDemand, Vi Web, MediAsst, Allscripts, Advanced Web, Meditech, ClaimLogic, and HealthStream.
- Maintained current knowledge of payer guidelines and accepted insurance plans, including PPO, HMO, Medicare, and Medi-Cal.
- Communicated effectively with patients, physicians, and cross-functional teams to resolve account discrepancies and expedite claim resolution.
- Applied expertise in CPT, HCPCS, and ICD billing codes, authorization protocols, and supporting documentation requirements.
- Trained and mentored new employees, promoting best practices and ensuring consistent performance across the team.
Billing Specialists
Medicus Results
12.2012 - 03.2015
- Working directly with insurance companies, healthcare providers, and patient to get claims process and paid.
- Completed insurance collections for PPO, Medicare, Medi-Cal, and Workers’ Compensation claims, ensuring timely follow-up and resolution of outstanding balances.
- Review insurance underpayments, denials, and unpaid appealed claims.
- Verify patient insurance.
- Answer patient billing questions.
- Prepare, review, and mailed patient statements
- Process insurance EOB's and patient payments.
- Post all insurance and patient payments.
Education
Medical billing and Coding -
American Career College
12.2012
High School - undefined
Loara High School
01.2004
Skills
- Training and mentoring
- Goal oriented
- Staff management
- Customer service
- Complex Problem-solving
- Cash Posting and Reconciliation expert
- Strong decision-making and critical thinking skills
- Proficient in UB04, CMS-1500, and coding
- Proficient in CPT, HCPCS, and ICD-10 coding standards
- Over 10 years of hands-on experience across the full spectrum of revenue cycle
Timeline
Supervisor Insurance Services
R1 RCM
04.2019 - Current
Sr. Collection Rep
St Joseph Heritage/ Medirevv
04.2016 - 04.2019
A/R specialist
Conifer Health
03.2015 - 11.2015
Billing Specialists
Medicus Results
12.2012 - 03.2015
High School - undefined
Loara High School
Medical billing and Coding -
American Career College
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