BIBIANA CASILLAS
UTMB
Dickinson,TX
1
Language
7
years of professional experience
Experienced billing and denials specialist with strong analytical thinking, documentation management, and problem-solving skills. Skilled in resolving claim denials, improving AR performance, and supporting accurate reimbursement.
Work History
HB Billing and Denials Specialist
1 Year 11 Months- Coordinated daily administrative workflows, supporting accurate scheduling, documentation, and follow-up activities.
- Processed confidential records and data entries, maintaining compliance with institutional and regulatory standards.
- Resolved routine service requests, providing timely support to patients, staff, and internal departments.
- Monitored work queues and prioritized tasks to maintain efficient turnaround and consistent service quality.
- Managed and actively monitor assigned AR to ensure timely and accurate reimbursement.
- Analyze aging reports and prioritize accounts based on dollar value, age, payer, denial reason, and likelihood of recovery.
- Developed and execute effective strategies to reduce outstanding AR and prevent accounts from becoming significantly aged.
- Identify trends in unpaid, underpaid, and delayed claims.
- Maintain accurate documentation of collection activities, claims status, follow-up efforts, and payor communications
- Escalate high-dollar, complex, or unresolved accounts appropriately.
- Conduct detail reviews of rejected, denied, and underpaid medical claims to determine the root cause of nonpayment.
- Researched payer policies, contracts, medica necessity requirements, coding guidelines, authorization requirements, and claim submission rules.
- Determine wether issues are related to coding, billing, authorization, eligibility, documentation, bundling, medica necessity, timely filing, payer processing, or other reimbursement requirements.
- Prepare and submit corrected claims, reconsiderations, appeals, and supporting documentation as appropriate.
- Follow claims through the resolution process and ensure appropriate payment is received.
- Identify recurring denial patterns and recommend corrective action to prevent future denials.
Billing Department Manager
1 Year 11 Months- Managed billing workflows for patient accounts, insurance claims, and reimbursement follow-up
- Reviewed coding accuracy, claim edits, and denial issues to support clean claim submission
- Coordinated staff assignments, daily priorities, and billing department coverage
- Resolved outstanding balances, payment discrepancies, and patient billing inquiries with professionalism
- Trained billing staff on charge entry, claim processing, and payer requirements
- Implemented process improvements for charge capture, claim submission, and denial resolution
- Maintained compliance with payer guidelines, HIPAA standards, and internal billing procedures
- Monitored aging reports, collections activity, and account adjustments to improve revenue cycle consistency
- Handled escalated customer inquiries related to invoicing discrepancies by conducting thorough investigations and implementing appropriate resolutions.
- Coordinated with finance department on revenue forecasting, providing valuable insights into budget planning efforts.
- Maintained open communication lines between the billing department and other internal teams, fostering a collaborative work environment.
- Managed a team of billing specialists, ensuring timely and accurate invoicing for clients.
- Reviewed billing problems, researched issues, and resolved concerns.
- Trained and mentored staff on procedures, compliance requirements, and collections techniques.
- Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
- Improved office operations by automating client correspondence, record tracking and data communications.
- Created reports, presentations and other materials for executive staff.
- Coordinated office events, seminars and meetings for staff and clients.
- Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
Billing Manager/Front Desk Manager
2 Years 3 Months- Directed billing workflows for OB/GYN and aesthetics services, ensuring accurate claim submission and payment posting.
- Trained billing staff on insurance verification, charge capture, and denial follow-up procedures.
- Reviewed patient accounts to resolve discrepancies, reduce aging balances, and maintain clean records.
- Coordinated prior authorizations and referrals for covered procedures and specialty services.
- Monitored claim denials, identified root causes, and implemented corrections for recurring billing errors.
- Managed collections processes with front office and clinical teams to improve account resolution.
- Audited coding and documentation for compliance with payer requirements and internal policies.
- Streamlined billing operations by standardizing workflows, improving accuracy, and supporting revenue cycle efficiency.
- Reduced errors and discrepancies in invoicing by closely monitoring billing data and conducting regular audits.
- Implemented policies that improved accounts receivable collections, resulting in reduced outstanding balances and increased cash flow.
- Boosted team productivity through effective delegation of tasks, setting performance targets, and providing constructive feedback.
- Created a transparent work environment that fostered open communication between team members, promoting collaboration and problem-solving skills development.
- Developed comprehensive training materials for new hires to quickly acclimate them to company procedures and software systems.
- Established performance metrics for evaluating staff effectiveness, leading to continuous improvement initiatives within the department.
- Boosted cash flow with effective billing strategies, closely monitoring aging reports and prioritizing high-value accounts for collection efforts.
- Led training sessions for new billing software, increasing department efficiency and ensuring seamless transition for all team members.
- Developed comprehensive billing guidelines, standardizing procedures across department and reducing variability in outcomes.
- Supported financial director with special projects and additional job duties.
- Coordinated scheduling across OB/GYN and aesthetics services, reducing conflicts and missed visits.
- Trained front desk staff on phone etiquette, HIPAA compliance, and reception procedures.
- Resolved patient concerns promptly, delivering professional service and minimizing wait-time frustration.
- Trained new staff on correct procedures, compliance requirements, and performance strategies.
- Mentored and trained new hires, fostering a supportive work environment that facilitated professional growth.
- Kept accounts in balance and ran daily reports to verify totals.
- Responded to telephone, email and in-person inquiries regarding reservations, hotel information and guest concerns.
- Oversaw daily cash reconciliations, maintaining accurate financial records for the front desk department.
- Managed front desk maintenance of client records and lab data.
- Managed team schedules, ensuring adequate staffing levels for optimal front desk operations.
- Handled tasks and responsibilities for front office employees during periods of understaffing.
- Controlled cash and credit card payment transactions at front desk to successfully reduce errors.
- Hired and trained new employees, demonstrating best methods for serving clients and guests.
Education
No Degree - Medical Billing And Cooding
No Degree - Medical Billing And Coding
High School Diploma
Skills
Customer relations
Expert problem solving
Analytical thinking
Documentation management
Advanced communication
Technical communication
Proficient in E-clinicals and Epic.
Languages
Spanish
Full Professional
Timeline
HB Billing and Denials Specialist
UTMB
11.2024 - CurrentRead More
Billing Department Manager
Plaza Obgyn Associates
08.2022 - 07.2024Read More
Billing Manager/Front Desk Manager
Ambany Center for Obgyn and Aesthetics
04.2020 - 07.2022Read More
University of Houston-Clearlake Campus
No Degree from Medical Billing And Cooding
Read More
National Institute of Technology
No Degree from Medical Billing And Coding
Read More
Jesse H Jones Highschool
High School Diploma
Read More