Hidda M Santiago Velez

• Generated reports and analyzed trends to maximize reimbursement and reduce claim denials.
• Accountable for maintaining and improving key performance indicators for assigned clients.
• Ran Weekly A/R aging reports; decreased accounts in A/R of 0-60% by 7% overall.
• Log all client issues encountered in internal tracking system, including enhancement requests, bugs, errors and inquiries.
• Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
• Manage patient collection process, produce monthly reports, and perform month end process/reports for designated clients.
• Reviewed outstanding requests and redirected workloads to complete projects on time.
• Engage in regular client interaction via email and conference calls. Manage first level client escalations.
• Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
• Submitted electronic/paper claims documentation for timely filing.
• Monitored and updated claims status in claims processing system
• Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
• Modified, updated and processed existing policies.
• Delivered timely and accurate charge submissions.
• Identified root cause of denials to provide plans for denial resolution.

• Responsible for A/R follow-ups for variety of specialties including OB/GYN, Critical Care, rauma, internal medicine, and cardiology. Worked with major insurance companies to settle payments, reconciled medical documentation with physician charges to support accurate billing to third parties.
• Responsible for managing Spanish voicemail messaging for handling of customer inquiries Assist Collections Department in collections calls to Spanish-speaking households.
• Coordinate with major insurance companies, including but not limited to: Medicare, Blue Cross - Blue Shield, AARP, Cigna, United Health Care, and Local Health Plans & Medicaid
• Obtain and submit copies of medical documentation with physician charges to support billing to third-party payers.
• Analyze and resolve physician claim rejects and denials from billing system or insurance carriers, as related to coding issues Prepare billing monthly reports

Trained and lead office team in initiating patient claims for internal medicine specialty by accurately identifying physician services rendered to prevent rejections or denials from patient's insurance carriers or billing system.

• Assisted in reconciling deposit and patient collections
• Processed online and paper appeal submissions and refund requests
• Processed billing calls and answered questions from patients and third-party carriers
• Corrected, completed and processed claims for multiple payer codes
• Coordinate with major insurance companies, including but not limited to: Medicare, Tricare, Blue Cross – Blue Shield, AARP, Cigna, United Health Care, Local Health Plans & Medicaid
• Review medical record documentation to identify all physician-provided services
• Obtain and submit copies of relevant medical documentation with physician charges to support billing third-party payers.
• Prepare billing monthly reports.
• Identify trends/problems in medical documentation and department request issue, and recommend possible solutions.