Caridad Maldonado
Hudson
Summary
Detail-oriented Billing Manager with expertise in medical coding and billing compliance. Proven ability to lead teams, resolve discrepancies, and enhance billing processes for improved efficiency.
Overview
41
41
years of professional experience
Work History
Billing Manager
Nashua Eye Associates
Nashua, New Hampshire
12.2022 - Current
- Managed billing processes for patient accounts and insurance claims.
- Reviewed and ensured accuracy of medical coding for compliance and reimbursement.
- Coordinated with healthcare providers to resolve billing discrepancies.
- Analyzed billing reports to identify trends and improve operations.
- Facilitated communication between departments regarding billing inquiries and issues.
- Managed and reviewed medical billing staff to ensure accuracy of patient accounts.
- Resolved issues related to denied or rejected payments from insurance companies.
- Monitored accounts receivable aging reports and worked proactively to reduce outstanding balances due from patients or insurers.
- Oversaw the preparation of monthly billing reports and analysis to track billing efficiency and accuracy.
- Led the transition to electronic billing systems, significantly reducing paper use and contributing to sustainability goals.
- Established clear billing policies and procedures, ensuring consistent application across all client accounts.
- Maintained regular performance appraisals for subordinates through verbal, written and on-going review programs.
Billing
Lumineyes Associates
Nashua, New Hampshire
10.2019 - 12.2022
- Researched and resolved customer inquiries regarding billing issues.
- Resolved billing discrepancies with insurance companies and patients.
- Managed client accounts including billing inquiries, account updates.
- Answered customer questions regarding billing issues.
- Reviewed customer accounts and identified discrepancies in billing information.
- Reconciled discrepancies between customer records and billing statements.
- Resolved billing and service issues for customers.
- Managed administrative tasks related to scheduling appointments, billing.
- Assisted customers with inquiries regarding billing information, account status.
- Verified insurance coverage and managed billing processes.
- Researched and resolved customer disputes regarding billing issues.
- Researched discrepancies in order processing and billing issues.
- Analyzed customer accounts to ensure accuracy of billing information.
Billing Specialist/Customer Service Department
John Hancock Insurance Services
Andover, MA
06.1985 - 2010
- Processed and verified billing statements for accuracy and compliance with company policies.
- Managed customer inquiries regarding billing discrepancies, ensuring timely resolution.
- Utilized billing software to generate invoices, improving efficiency in payment processing.
- Collaborated with cross-functional teams to streamline billing workflows and enhance service delivery.
- Conducted regular audits of accounts receivable, identifying opportunities for process improvements.
- Developed training materials to support ongoing education in billing practices and software usage.
- Researched and resolved billing discrepancies to enable accurate billing.
- Worked with multiple departments to check proper billing information.
- Guided team members in resolving complex billing discrepancies, promoting a culture of cooperation and shared expertise within the department.
- Collaborated with the collections team to recover overdue payments from clients, maintaining cash flow and minimizing writeoffs.
- Maintained detailed records of each account''s payment history, providing easy access to information for audit and analysis purposes.
- Enhanced customer satisfaction with timely and accurate invoice generation.
- Maximized revenue potential by identifying and resolving under-billed accounts.
- Strengthened client relationships through effective communication regarding billing issues and concerns.
- Collaborated with healthcare team to ensure billing codes were accurately applied, optimizing reimbursement from insurance companies.
- Maintained up-to-date knowledge of billing regulations and compliance requirements, ensuring adherence to legal standards.
- Increased revenue retention by setting up follow-up system for outstanding payments.
- Reduced billing errors, leading to decrease in customer complaints, by conducting regular audits of billing data.
- Negotiated with insurance companies to resolve disputed claims, securing rightful payments.
- Fostered strong relationships with healthcare providers and insurance representatives to facilitate efficient resolution of billing issues.
- Improved customer satisfaction with prompt and clear communication regarding their billing inquiries.
- Proactively addressed potential billing discrepancies by conducting pre-billing audits.
- Enhanced interdepartmental communication to ensure accuracy and completeness of billing information.
- Responded to customer concerns and questions on daily basis.
- Collaborated with customers to resolve disputes.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
- Supervised daily operations to ensure high-quality customer service delivery.
- Trained and mentored staff to enhance team performance and service standards.
- Implemented process improvements that increased efficiency in handling customer inquiries.
- Promoted a positive work environment through open communication channels, fostering team collaboration and high morale.
- Monitored key performance indicators to assess team effectiveness and drive continuous improvement.
- Improved customer satisfaction by addressing and resolving escalated issues promptly and professionally.
- Coached employees through day-to-day work and complex problems.
Durable Medical Billing Specialist
Acelleron Medical
Andover, MA
10.1996 - 2002
- Processed medical claims efficiently, ensuring accuracy in billing and coding procedures.
- Resolved billing discrepancies by communicating with insurance providers and patients.
- Maintained up-to-date knowledge of healthcare regulations and compliance standards.
- Collaborated with healthcare teams to streamline billing workflows and enhance revenue cycle management.
Education
High School Diploma -
Lawrence High School
Lawrence, MASkills
- Medical coding
- Billing compliance
- Accounts receivable
- Electronic billing
- Data analysis
- Healthcare billing
- Performance appraisal
- Team leadership
- Problem solving
- Attention to detail
- Payment posting
- Staff training and development
- Billing review
- Process improvement
- Audit support
- Project management
- HIPAA
- Insurance verification
- Claims processing
- Revenue cycle management
- Teamwork
- Multitasking Abilities
- Professionalism
Languages
Spanish
Professional
Education and Training
other
Timeline
Billing Manager
Nashua Eye Associates
12.2022 - Current
Billing
Lumineyes Associates
10.2019 - 12.2022
Durable Medical Billing Specialist
Acelleron Medical
10.1996 - 2002
Billing Specialist/Customer Service Department
John Hancock Insurance Services
06.1985 - 2010
High School Diploma -
Lawrence High School