Carmen Aviles

• Managed complex operating room billing processes while ensuring accurate charge capture, documentation review, and regulatory compliance.
• Improved billing operations through process enhancements, increasing efficiency and reducing claim processing turnaround times.
• Enhanced billing operations through process improvements, achieving more efficient claim processing and reducing turnaround times.
• Achieved exceptional accuracy through thorough account reviews, auditing support, quality assurance measures, and charge reconciliation.
• Monitored open surgical cases and billing work queues to ensure timely resolution of outstanding charges and documentation issues.
• Monitored open surgical cases and billing work queues, ensuring timely resolution of outstanding charges and documentation issues.
• Participated in cross-functional teams to support OR Surgical Schedulers, facilitating effective communication and ensuring timely case updates and workflow coordination.
• Served as a resource for resolving complex billing inquiries and coordinating issue resolution across multiple departments..

• Spearheaded prior authorization and insurance verification processes, supporting efficient patient intake and reducing delays in care.
• Optimized appointment and procedure scheduling through effective use of GE IDX and Epic systems, improving accuracy and workflow efficiency.
• Managed copayment collections and high-volume, multi-line telephone communications while providing outstanding patient service.
• Monitored open operating room cases, ensuring timely follow-up and communication with physicians and clinical staff.
• Processed post-procedure charges accurately to support timely billing and maintain complete patient records.
• Coordinated patient appointments and physician schedules to maximize provider availability and operational efficiency.
• Managed incoming correspondence, including emails, phone messages, and mail, ensuring prompt distribution and follow-up.
• Prioritized competing responsibilities in a fast-paced environment while consistently meeting deadlines and maintaining accuracy.
• Ordered and maintained office and clinical supplies to support daily operations and prevent inventory shortages.
• Handled high-volume incoming and outgoing calls, accurately documenting and relaying messages to appropriate personnel.
• Facilitated effective communication by receiving, screening, and directing calls, emails, and written correspondence to the appropriate departments and staff members.

• Directed front office operations, including appointment scheduling, telecommunications, and patient information management, contributing to improved patient satisfaction and workflow efficiency.
• Coordinated financial functions such as copayment collection, fee slip processing, and daily financial reporting to support accurate billing and revenue capture.
• Ensured compliance with hospital policies and procedures while coordinating patient care services and administrative operations.
• Served as a liaison between healthcare providers, clinical staff, and administrative departments, facilitating effective communication and timely resolution of issues.
• Managed scheduling for multiple providers and departments, optimizing resource utilization and operational efficiency.
• Maintained accurate patient records and documentation while ensuring confidentiality and regulatory compliance.
• Supported daily office operations by prioritizing competing demands, managing administrative tasks, and maintaining high standards of customer service.
• Assisted patients with inquiries regarding appointments, insurance, billing, and care coordination, ensuring a positive patient experience.
• Developed and maintained productive relationships with physicians, healthcare professionals, and support staff to promote seamless patient care delivery.
• Monitored workflow processes and identified opportunities to improve efficiency, accuracy, and service quality.

Graduated with President's List Honors