ERICA SERNA
Cypress,CA
Summary
Healthcare revenue cycle professional with a strong background in billing management, team leadership, and problem-solving. Demonstrated ability to manage complex accounts, implement process improvements, and ensure compliance, contributing to effective operations and high-quality patient service. Bilingual in English and Spanish, facilitating effective communication in diverse settings.
Overview
27
27
years of professional experience
Work History
Collection Representative - Professional Billing
University of California, Irvine (UCI Health)
Anaheim, CA
06.2024 - Current
- Reviewed complex billing accounts by checking claim status, payer replies, denials, coverage rules, authorization needs, and account records.
- Checked payer guidelines, eligibility, benefits, authorization needs, and claim-processing policies to support correct reimbursement and account resolution.
- Worked with authorization, billing, clinical, and revenue cycle teams to resolve account issues and support timely outcomes and patient satisfaction.
- Researched unpaid and denied claims to find root causes and determine follow-up actions through reconsideration, appeal, correction, or escalation.
- Escalated complex billing and reimbursement issues to leadership and operational teams with clear documentation and next-step recommendations.
- Kept account notes detailed and accurate to support continuity, compliance, and timely resolution.
- Helped patients with billing questions, insurance concerns, and account resolution while providing professional customer service.
Business Office Supervisor
St. Joseph Hospital - Hematology & Oncology Medical Group
Orange, CA
10.2012 - 05.2024
- Supervised daily business office operations supporting medical billing, collections, registration, scheduling, patient accounts, and administrative functions.
- Provided leadership, training, coaching, and day-to-day support to administrative and billing staff.
- Supported revenue cycle functions including insurance verification, billing follow-up, collections, account reconciliation, and patient financial services.
- Resolved escalated patient accounts, billing concerns, and insurance issues, facilitating complex account resolutions for staff.
- Performed account audits and quality reviews, identifying errors to enhance billing accuracy.
- Identified workflow challenges and implemented process improvements, streamlining operations and enhancing staff productivity.
- Maintained compliance with HIPAA requirements and organizational policies regarding confidential patient and financial information.
- Served as a liaison between physicians, staff, patients, insurance companies, and other departments to resolve billing and operational issues.
Medical Collection Manager
Interstate Debt Managers
Cypress, CA
03.2000 - 12.2011
- Managed daily medical collection operations and supervised staff handling high-volume healthcare accounts to ensure timely recovery.
- Developed collection strategies to improve account recovery and reduce outstanding balances.
- Reviewed escalated accounts and guided staff on complex collection and resolution issues to enhance recovery outcomes.
- Identified workflow inefficiencies and standardized processes, resulting in improved departmental performance.
- Communicated with patients, healthcare organizations, and other external parties to resolve account discrepancies.
- Maintained professional and compliant collection practices while managing sensitive patient financial information.
Education
Medical Assistant Certificate -
Concorde Career College
Garden Grove, CA05-2012
High School Diploma -
Magnolia High School
Anaheim, CA06-1999
Skills
- Claims resolution
- Insurance eligibility
- Patient billing
- Billing operations
- Billing procedures
- Revenue cycle management
- Account reconciliation
- Regulatory compliance
- Epic
- Microsoft
- Team leadership
- Patient interaction
LANGUAGES
Spanish, Bilingual
Timeline
Collection Representative - Professional Billing
University of California, Irvine (UCI Health)
06.2024 - Current
Business Office Supervisor
St. Joseph Hospital - Hematology & Oncology Medical Group
10.2012 - 05.2024
Medical Collection Manager
Interstate Debt Managers
03.2000 - 12.2011
Medical Assistant Certificate -
Concorde Career College
High School Diploma -
Magnolia High School