Graciela Suarez, CCS
Bakersfield,CA
Summary
Certified Coding Specialist (CCS) with 14+ years of healthcare experience specializing in medical coding, E/M coding, and revenue cycle operations in high-volume clinical environments. Skilled in accurate code assignment, documentation review, coding audits, and denial resolution to support compliant billing and optimal reimbursement. Experienced in analyzing medical records, identifying coding discrepancies, and ensuring adherence to coding guidelines and payer regulations. Proven collaborator with providers and leadership teams to improve coding accuracy, compliance, and departmental best practices. Bilingual English/Spanish professional experienced supporting diverse patient populations in fast-paced healthcare settings.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Medical Biller / Coder
Priority Urgent Care
2023.03 - 2026.03
- Performed charge entry and E/M coding for urgent care encounters ensuring accurate reimbursement.
- Verified coding accuracy, sequencing of diagnoses, and procedure details to support correct claim submissions.
- Resolved insurance denials and prepared appeals to recover outstanding claim payments.
- Conducted coding and billing audits to ensure compliance and enhance claim accuracy, reducing potential reimbursement issues.
- Managed full accounts receivable workflow, overseeing aging review, insurance follow-ups, and payment resolution to ensure timely payments.
- Processed medical claims for HMO, PPO, Medi-Cal, Medicare and all major insurance providers efficiently.
- Ensured compliance with coding regulations and insurance guidelines.
- Developed Standard Operating Procedures (SOPs) to standardize billing processes and improve workflow efficiency.
- Collaborated with billing leadership and management to implement updated department best practices.
- Partnered with supervisors on revenue cycle improvement initiatives and department projects.
Authorization Coordinator / Medical Assistant
Kern Vascular Center
Bakersfield, California
2021.04 - 2023.02
- Processed prior authorizations for radiology and vascular procedures supporting high‑volume patient scheduling.
- Managed authorization documentation and tracked requests for over 600 patients monthly.
- Verified insurance coverage and eligibility prior to procedures.
- Resolved authorization denials through direct communication with insurance carriers.
- Guided patients in understanding insurance coverage options, enhancing their ability to navigate the healthcare system.
- Facilitated communication between departments on authorization procedures, improving workflow and collaboration.
- Developed training materials for new Authorization Coordinators and staff members.
- Managed patient scheduling and coordinated appointments effectively and prepared patient prior to procedure time.
Eligibility / Authorizations Specialist
Around The Clock Home Health
Bakersfield, California
2020.01 - 2021.02
- Verified patient eligibility across Medicare, Medi‑Cal, HMO, PPO, and commercial insurance plans to facilitate seamless patient access.
- Maintained accurate eligibility documentation to ensure compliance with payer requirements and support operational integrity.
- Processed 50–60 daily insurance authorizations for timely delivery of home health services.
Medical Front Office / Assistant
Short Term Medical Positions
Bakersfield, California
2019.03 - 2020.12
- Managed patient scheduling and appointment coordination for multiple healthcare professionals.
- Coordinated patient registration, scheduling, and insurance verification to streamline front office operations.
- Supported medical staff by managing administrative operations and optimizing patient workflow.
- Provided administrative support by answering phone calls and addressing inquiries promptly.
- Maintained organized patient records and ensured confidentiality compliance standards.
Medical Assistant / Billing Specialist
Superior Healthcare
Bakersfield, California
2013.10 - 2019.02
- Supported a high‑volume medical office serving 200+ patients daily.
- Submitted electronic and paper claims to Medicare, Medi‑Cal, Blue Cross, Blue Shield, Cigna, Aetna, and UnitedHealthcare.
- Processed 100–150 insurance claims daily while ensuring accurate coding and documentation.
- Managed accounts receivable and patient billing activities to ensure accurate financial tracking and collection.
- Coordinated Workers’ Compensation and personal injury billing cases with legal offices to facilitate claims processing.
- Educated patients on treatment plans and health maintenance strategies.
- Relayed patient messages to physicians regarding concerns, condition updates, or refill requests to support timely treatment.
- Collected, labeled and stored laboratory specimens properly prior to testing.
Education
LICENSE - PHLEBOTOMY
PHLEBOTOMY USA
Bakersfield, CA2022-10
LICENSE - CNA
Bakersfield College
Bakersfield, CA2022-06
Certificate - Medical Billing And Coding
Ultimate Medical Academy
Clearwater, FL2012-08
Associate of Arts - Liberal Arts
Bakersfield College
Bakersfield, CA2004-06
Skills
- E/M Coding & Documentation Review
- Proficiency in ICD-10 and CPT, HCPCS
- Charge Entry & Claim Submission
- Denial Management & Appeals
- Insurance Payment Reconciliation
- Billing Audits & Compliance
- Revenue Cycle Optimization
- Insurance verification
- Insurance plans management
- Software proficiency
- Accounts receivable
- Medical record security
- Multitasking and organization
Certification
Certified Coding Specialist (CCS), 04/25
Additional Information
English / Spanish, 45 WPM, True
Languages
Spanish
Professional
Timeline
Medical Biller / Coder
Priority Urgent Care
2023.03 - 2026.03
Authorization Coordinator / Medical Assistant
Kern Vascular Center
2021.04 - 2023.02
Eligibility / Authorizations Specialist
Around The Clock Home Health
2020.01 - 2021.02
Medical Front Office / Assistant
Short Term Medical Positions
2019.03 - 2020.12
Medical Assistant / Billing Specialist
Superior Healthcare
2013.10 - 2019.02
LICENSE - PHLEBOTOMY
PHLEBOTOMY USA
LICENSE - CNA
Bakersfield College
Certificate - Medical Billing And Coding
Ultimate Medical Academy
Associate of Arts - Liberal Arts
Bakersfield College