ENRIQUETA J. ESPINOZA
Billing Specialist
Victorville,CA
Summary
Driven Medical Biller motivated to perform beyond expectations.
Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors. Confident Medical Biller knowledgeable in data confidentiality and privacy practices when reviewing patient information.
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Medical Billing Specialist
Phoenix House of CA
01.2024 - 05.2026
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
- Conducted regular audits of patient accounts for potential underpayments or overpayments due to incorrect coding or billing practices.
- Reduced errors in medical billing by meticulously reviewing patient records and ensuring accurate coding.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Posted payments and collections on regular basis.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
Medical Billing Specialist
St John of God Health Care Services
11.2020 - 12.2023
- Reviewed and processed medical claims for accuracy and compliance with regulations.
- Maintained detailed records of billing transactions using electronic health record (EHR) systems.
- Trained new staff on billing procedures, software applications, and regulatory requirements.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Coordinated with other departments to address any discrepancies or concerns related to charge capture or data entry accuracy.
- Efficiently processed refunds or adjustments for patients when necessary, ensuring accuracy and compliance with company policies.
- Participated in departmental meetings, sharing insights and ideas for improving overall medical billing efficiency and revenue generation.
Store Manager
SJOG Second Time Around Thrift Store
08.2007 - 11.2020
- Oversaw daily store operations, ensuring compliance with organizational policies and procedures.
- Trained and mentored staff, fostering a collaborative and efficient team environment.
- Implemented inventory management systems, optimizing stock levels and reducing waste.
- Developed and executed sales strategies to enhance customer engagement and drive revenue growth.
- Coordinated community outreach efforts to strengthen brand presence and support local initiatives.
- Managed budgeting processes, controlling expenses while maximizing resource allocation
- Assisted with hiring, training and mentoring new staff members.
- Mentored new hires during their onboarding process, ensuring they were well-equipped to excel in their roles from day one.
- Rotated merchandise and displays to feature new products and promotions.
- Implemented customer feedback system to address and quickly rectify any issues, thereby enhancing customer loyalty.
- Reduced employee turnover by creating supportive work environment and recognizing outstanding performance.
Education
High School Diploma -
CCAPP
Sacramento, CA01-2025
RADT - 1461220322 -
CCAPP
Sacramento, CA01-2025
Skills
- Auditing
- Financial Accounting
- Financial Reporting
- Payment posting
- Claim submission
- HIPAA compliance certification
- Insurance verification
- Patient billing
- Denial management
- Medicare and medicaid process
- Bill payment
- Files and records management
- Collections management
- Critical thinking
- Customer service
- Teamwork and collaboration
Accomplishments
Prevention Advocate of the year - San Bernardino County
Certification
- DATAR Training - 2022
- FEMA- Disaster Response
- CPR
Languages
English
Full Professional
Spanish
Full Professional
Timeline
Medical Billing Specialist
Phoenix House of CA
01.2024 - 05.2026
Medical Billing Specialist
St John of God Health Care Services
11.2020 - 12.2023
Store Manager
SJOG Second Time Around Thrift Store
08.2007 - 11.2020
High School Diploma -
CCAPP
RADT - 1461220322 -
CCAPP