Caridad Maldonado
Hudson,NH
Summary
Billing manager with a background in medical coding, billing compliance, and healthcare claims support. Manages denied claims, accounts receivable follow-up, billing discrepancies, and staff guidance while improving billing accuracy through reporting, policy updates, and electronic workflow changes.
Overview
42
42
years of professional experience
Work History
Billing Manager
Nashua Eye Associates
Nashua, New Hampshire
12.2022 - 12.2026
- Streamlined billing processes for patient accounts and insurance claims to enhance accuracy.
- Managed medical billing staff to ensure accuracy of patient accounts and foster team development.
- Resolved denied and rejected insurance payments.
- Worked with healthcare providers to fix billing discrepancies.
- Monitored accounts receivable aging reports and followed up on overdue patient and insurer balances.
- Reviewed billing reports to identify trends and implement improvements in daily operations.
- Prepared monthly billing reports and reviewed results to track billing accuracy and efficiency.
- Created billing policies and procedures for consistent use across client accounts.
- Helped move billing work to electronic systems, reducing paper use and supporting sustainability goals.
Billing
Lumineyes Associates
Nashua, New Hampshire
10.2019 - 12.2022
- Resolved billing discrepancies with insurance companies and patients.
- Verified insurance coverage and facilitated billing processes to ensure accurate and timely billing.
- Managed client accounts, addressing billing inquiries and performing account updates to enhance customer satisfaction.
- Reviewed customer accounts and identified discrepancies in billing information.
- Reconciled discrepancies between customer records and billing statements, ensuring consistency and accuracy.
- Researched and resolved customer inquiries regarding billing issues.
- Researched and resolved customer disputes regarding billing issues.
- Analyzed customer accounts to ensure accuracy of billing information.
- Researched discrepancies in order processing and billing issues.
- Managed administrative tasks related to scheduling appointments, billing.
Customer Service Supervisor
John Hancock
Andover, MA
06.1985 - 10.2000
- Supervised customer service team handling policy service and account inquiries for John Hancock clients.
- Monitored calls and cases for compliance with John Hancock service standards and procedures.
- Coached representatives on claim support, policy changes, and difficult customer conversations.
- Resolved escalated complaints involving annuities, insurance products, and billing questions.
- Reviewed customer records in service systems for accurate updates and issue follow-up.
- Coordinated daily workflow across queues to support John Hancock service operations.
- Trained new hires on customer service scripts, product knowledge, and documentation practices.
- Partnered with internal departments to process requests and address service delays.
- Assisted customers with product inquiries and resolving complaints promptly and professionally.
- Answered phone calls and responded to questions and concerns.
- Resolved escalated customer disputes in a timely manner while maintaining good relationships with customers.
- Supervised and trained customer service staff to ensure excellent customer service delivery.
- Established positive rapport with customers, managers and customer service team members to maintain positive and successful work environment.
- Ensured all customer inquiries were handled in accordance with company standards and regulations.
- Evaluated employee job performance and motivated staff to improve productivity.
- Monitored customer service performance metrics, such as call response times, resolution rates, and customer satisfaction ratings.
- Prepared work schedules based on staff availability and forecasted demands to optimize personnel coverage.
- Addressed customer inquiries to increase customer satisfaction ratings.
- Provided guidance and support to junior customer service representatives, including coaching and mentoring.
- Collaborated closely with upper management on projects involving new initiatives or improvements within the department.
- Created reports on daily, weekly, monthly basis related to customer service activities.
- Investigated sensitive customer service complaints and delivered prompt resolution to customer satisfaction.
- Assisted staff with resolving complex customer issues and implementing targeted solutions.
- Identified areas of improvement in the customer service process and developed strategies to address them.
- Maintained knowledge of company products and services to promptly resolve complaints and concerns.
- Set clear expectations and helped employees pursue optimal paths for achieving each target.
- Monitored phone calls to promote better service and provide feedback.
- Assessed team member performances by delivering one-on-one coaching to promote better service.
- Communicated regularly with other departments regarding any changes in policy or procedure that may affect customers.
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
- Medical billing
- Insurance claims
- Revenue cycle
- Claim adjudication
- Denial management
- Billing reconciliation
- Policy development
- Team building
- Collections management
- Time management
Languages
Spanish
Timeline
Billing Manager
Nashua Eye Associates
12.2022 - 12.2026
Billing
Lumineyes Associates
10.2019 - 12.2022
Customer Service Supervisor
John Hancock
06.1985 - 10.2000
High School Diploma -
Lawrence High School