Summary
Overview
Work History
Education
Skills
Timeline
Generic

Billie Lujan

San Antonio

Summary

Billing professional, prepared for overseeing billing operations and ensuring seamless financial processes. Expertise in managing billing cycles and resolving discrepancies to maintain accuracy. Known for fostering team collaboration and adapting to evolving business needs with precision and reliability.

Overview

12
12
years of professional experience

Work History

Billing Supervisor

Here We Grow Pediatrics
01.2023 - Current
  • Ensure billing and coding for all current and new medical service lines are accurate, consistent, and maximize revenue opportunities. Evaluate, report on, and improve results after implementation of new services or payers
  • Plan, implement, evaluate, and administer all Revenue Cycle strategies and processes, including authorization, eligibility and benefits verification, claims submission, payment posting for ERA’s, denial management, accounts receivable follow-up, reporting and aged claims.
  • Analyze current and potential contracts in terms of costing, volume, and reimbursement rates and use findings to drive contract strategies.
  • Send Patient statements and collections monthly- apply all patient and family credits prior to sending out statements.
  • Respond and research patient inquiries.
  • Daily batch total balanced.
  • Ensure ongoing knowledge and compliance with all contracts beyond initial implementation and throughout the full revenue cycle.
  • Monitor, respond to, and communicate changes in billing requirements, regulations, and reimbursement rates, and maintain provider enrollments with payers.
  • Update EMR and enter all information that has to do with billing, such as new codes, prices changes/increases, etc.
  • Credentialing Experience with quarterly CAQH updates.

Practice Manager/Billing Manager

Advanced Pain Management
05.2013 - 12.2022
  • Establish and implement effective workplace procedures.
  • Ensure policies and best practices are up to industry standards and government regulations.
  • Hire, train and monitor administrative staff.
  • Supervise daily practice operations such as billing, debt collections, security and occupational health and safety.
  • Monitor the inventory for medications and medical equipment and organize for resupply.
  • Interact with patients and address their complaints.
  • Coordinate regular staff meetings and performance reviews
  • Collaborate with Physicians to develop business strategies and patient services.
  • Interprets policies and procedures as established.
  • Plan and develop methods and procedures to obtain greater efficiency, which includes the coordination processing functions between the business office personnel and the clinical operations personnel.
  • Prepares and submits management reports as requested, both fiscal and operational.
  • Accomplishes projects in accordance with established timelines.
  • Perform human resource activities including but not limited to coordinating and assuring compliance with all federal, state and local employment laws and regulations as well as direct implementation of employee benefits.
  • Complete weekly and bi-weekly payroll, utilizing HR/Benefits software.
  • Responsible for all vendor invoices including auditing and preparation for remittance of all weekly, bi-weekly, monthly and quarterly vendor invoices
  • Administered on-boarding process for new employees and new-hire orientation program.
  • Knowledge of third-party payers, HMOs, PPOs, Medicare, Medicaid, Worker's Compensation, etc.
  • Knowledge and previous experience of CPT, ICD-10, code modifiers, and HCPCS codes.
  • Knowledge of ERAs, EOBs.
  • Knowledge of payer specific/LCD guidelines.
  • Understanding of health plan benefits (deductibles, copays, coinsurance) and eligibility verification.
  • Assist in implementing the day-to-day functions of the Billing department.
  • Oversee and streamline billing and collections processes.
  • Implement written policies and procedures that govern accounting functions.
  • Plan and implement quality assurance for all processes.
  • Post and review payments received to the appropriate patient's account.
  • Special program/billing planning and implementation.
  • Assist in balancing accounts receivable reconciling statements as needed.
  • Conduct routine staff meetings regarding billing planning and implementations.
  • Assist in standardizing the methods in which work will be accomplished.
  • Assist in preparing financial and statistical reports as directed.
  • Monitor and collect accounts receivables.
  • Assist in preparing monthly financial statements to include preparing monthly balance sheets, income reports, etc. as required/directed.
  • Maintain billing and payment log and complete all crossover billing as necessary or directed.
  • Assist patients with Billing Inquiries and Collections based on insurance coverage.

Front Office Supervisor/Insurance Verification/Authorizations/Referrals

01.2014 - 01.2016
  • Insurance verification to include PPO, HMO, Medicare, Medicaid, Workers’ Compensation
  • Obtain prior authorizations for all procedures and referrals.
  • Accurately enter notes into EMR regarding letters or correspondence from insurance companies regarding insurance authorization or other notifications.
  • Knowledge of CPT, ICD 10 coding and insurance plans such as Medicare, Medicaid, Workers Compensation, HMO's, IPA's, all commercial insurances.

Front Office Coordinator

01.2013 - 01.2014
  • Initial contact for all patient visits to the practice
  • Greet patients or visitors, confirm demographic information and collect payments as necessary
  • Answer multi line phone calls, schedule appointments, follow-ups and surgeries, take messages as needed
  • Check in/Check out process
  • Work closely with physician and medical assistants to accurately schedule all appointments
  • Handle EMR and assist in all administrative duties
  • Insurance verification to include PPO, HMO, Medicare, Medicaid
  • Coordinate all referrals, follow up and schedule all patients referred to the clinic.
  • Obtain prior authorizations for all procedures and referrals.

Education

High School Diploma -

Pharr San Juan Alamo High School
Pharr, TX
01.2000

Bachelor of Science - Healthcare Administration

Columbia Southern University
09.2025

Skills

  • Strong team building skills
  • Excellent written and verbal communication and interpersonal skills
  • Well-developed analytical, problem-solving skills and conflict resolution
  • Ability to work in fast paced environment with ability to multi-task as well as manage responsibilities with minimal supervision
  • Staff training, motivation and development
  • Service Quality Improvement
  • Certified Notary Public

Timeline

Billing Supervisor

Here We Grow Pediatrics
01.2023 - Current

Front Office Supervisor/Insurance Verification/Authorizations/Referrals

01.2014 - 01.2016

Practice Manager/Billing Manager

Advanced Pain Management
05.2013 - 12.2022

Front Office Coordinator

01.2013 - 01.2014

High School Diploma -

Pharr San Juan Alamo High School

Bachelor of Science - Healthcare Administration

Columbia Southern University

Similar Profiles

CREATE PROFILE