Results-oriented Medical Billing Manager specializing in claims processing and denial management. Expertise in enhancing revenue cycle efficiency and resolving complex billing issues. Strong background in medical coding and communication, facilitating effective patient account management and insurance collections.
Overview
1
1
Language
14
14
years of professional experience
Work History
Medical Insurance Biller/Follow up
Northern AZ Healthcare
09.2025 - Current
Managed billing, collection, credit, payments, and reconciliations, including manual re-bills and electronic submissions to payers to ensure accurate revenue flow.
Corrected, edited, and managed denied claims through work queues and correspondence, addressing issues such as Invalid CPT, Invalid DX, Missing Modifier, and Authorization/Referral to expedite resolution.
Follow-up includes telephone calls to payers and/or patients, as well as accessing payer websites, and resolving complex accounts with minimal or no assistance necessary.
Enter encounter notes, regarding rejections and follow up activities performed to enable others to review claim history on all encounters.
Performed account adjustments or write-offs in accordance with the "Write-Off" policy.
Coordinated internal communications with health centers regarding insurance billing and collections, facilitating timely information exchange and issue resolution.
Requested medical records from health centers to support insurance claims processing. from health centers as requested by the contracted insurance plans.
Corresponded with and assisted vendors involved with patient accounts. Reported safety-related incidents in a timely manner through the Midas/RDE tool; attended all safety training programs; performed work safely; monitored the work environment for potential safety issues and motivated others to work safely.
Medical Billing Manager
Flagstaff Urgent Care
06.2024 - 09.2025
Verify the accuracy of medical claims and process claims in a timely manner to receive accurate reimbursement. Must comply with all federal, state, and payer requirements.
Reviews medical claims and occupational health for accuracy, appropriate coding, ensuring timely claim submission to insurance companies on paper and/or EDI, and ensuring that the third party contractual agreements are met.
Processed insurance claims including Medicare/Medicaid, managed care and other commercial plans.
Followed up with insurance companies on claim rejections and unpaid accounts identified through aging reports, reporting trends and issues related to billing and reimbursements to Supervisor or Manager.
Researched and documented findings, communicating effectively with Supervisor and Manager to enhance overall billing performance.
Reviewed patient accounts to determine eligibility for refunds.
Assisted Spanish-speaking patients through check-in, vital checks, provider exams, and necessary follow-ups to ensure comprehensive patient care.
Supported Front Desk Agent in clarifying insurance-related questions to facilitate accurate copay, deductible, and coinsurance collections.
Ensured uninterrupted front desk operations by stepping in as a Front Desk Agent when required.
Accounting/ Admin Assistant
HOAMCO, Homeowners Associations Management Company
01.2020 - 04.2024
Facilitated timely invoice processing by generating check requests, ensuring accurate payment cycles.
Accounts Payable – Certificates of Insurance – W9 – Submit and approve Invoices – confirm proper operating GL codes are being used – reserves invoices (confirm the Bank Acct. GL number, expense acct. GL number, cost center) – Confirm invoices were paid.
Manage Association Information – Owner account information updates, Manage autopay/e-statements, Image and file association documents (DocuPhase), Financial reports, Compliance Violations/Supplemental Billing
Aging reports/collections, via phone, email and mail
Realtor requests – Master Insurance policies, Articles of Incorporation, Bylaws, CC&Rs, Rules and Regs
Manage Association Portal Website – Maintain current documents.
Maintain AZ Manager Association Disclosure Packets with our escrow department.
Aided community association managers by coordinating daily operational tasks, enhancing overall efficiency.
Contact a variety of vendors (city/county trash and recycle issues/WM, Water (city and local), water leaks, irrigation leaks, concrete repairs, street repairs, etc.).
Managed inventory of office supplies, maintaining optimal stock levels to support operational needs.
Running various errands including PO Box pickup.
Assist residents/owners/tenants with various issues relating to account questions, past due balances, maintaining proper and accurate contact information in our system Caliber.
Generate various claims, property trash bins and gate damage, property damage, and water damage.
Maintain a list of Rental/short term, AirBNB Rules and Regs, rental rules and regulations. Maintain current assessment, transfer, and disclosure fees, paid, working capital, Reserve and other fees and explanation.
Executive Assistant
Cordant Forensics Solutions
07.2016 - 09.2018
Coordinated office administrative functions by providing assistance, backup, and processing mail to ensure smooth operations.
Provide wide-ranging administrative support to the CEO and other executives working in multiple time zones, each with unique needs for support.
Managed executives' complex and often-changing calendars by scheduling meetings and video conferences.
Arrange travel and prepare itineraries including air and ground transportation, hotel reservations, out of town dining, and car rentals.
Work closely and effectively with the executive team to keep them informed of upcoming commitments and responsibilities, following up appropriately.
Facilitated planning and coordination of office-wide processes and events with internal and external stakeholders to enhance collaboration.
Prepare Board decks, presentations and supporting materials.
Draft communications on behalf of the CEO.
Reconcile business expenses and prepare and process expense reports.
Assist in coordinating the agenda of executive team meetings and site visits.
Prioritize conflicting needs, handle matters expeditiously with follow-through on projects to successful completion, often with deadline pressures.
Payroll Manager
Grand Canyon Railway, SW Xanterra Properties
02.2013 - 07.2016
Processed daily payroll duties, including filing and destroying confidential staff records, entering Arizona state and international taxes, handling time-off requests, updating employee job codes and pay rates, creating and updating direct deposit accounts, and issuing checks for discharged employees.
Completed final payroll tasks on Thursdays by entering last-minute requests, one-time deductions, and minimum wage confirmations for tipped employees, then uploaded balanced Kronos time records into Lawson accounting system before final report submission.
Balanced bi-weekly journal entries before assistant controller deadlines and completed preliminary reporting to identify discrepancies before reconciling and submitting final records.
Printed and bound required reports on Monday before payday, including check registers, GL detail, garnishments, and accrued vacation and sick time, then provided check and ACH numbers to accounting manager for check printing and distribution through Flagstaff and South Rim accounting offices.
Supported interdepartmental coordination by completing essential accounting functions and payroll support tasks.
Education
High School Diploma -
Sunnyside High School
Tucson, AZ
05-1997
Skills
Medical billing compliance
Claims processing
Claim adjudication
Denial management
Claim submission
Claims documentation
Insurance verification
Appeals handling
Payment posting
Billing software proficiency
Medical coding
ICD-10 proficiency
CPT coding
HCPCS level II coding
EDI submissions
Revenue cycle management
Insurance billing
Transaction oversight
Accounts receivable management
Accounts reconciliation
Patient account analysis
Refund processing
Data security
Denial resolution
Patient collections
Collections management
Insurance claims
Electronic claims
Medicare and medicaid process
Financial reporting
Timekeeping system management
EHR management
Health information systems
Medical terminology expert
Terminology mastery
Detail orientation
Data entry accuracy
Data security
Microsoft 365 mastery
Effective communication
Conflict resolution
Problem solving
Time management
Employee issue resolution
Patient interaction techniques
Patient confidentiality maintenance
Collections management
Submission efficiency
Time management
Insurance claims
CPT code modifiers
Data security
Electronic claims
Medicare and medicaid process
Insurance coding accuracy
HIPAA compliance certification
Revenue cycle management
Data security
Account reconciliation
Patient collections
Languages
Spanish
Native/ Bilingual
Timeline
Medical Insurance Biller/Follow up
Northern AZ Healthcare
09.2025 - Current
Medical Billing Manager
Flagstaff Urgent Care
06.2024 - 09.2025
Accounting/ Admin Assistant
HOAMCO, Homeowners Associations Management Company
Patient Account Representative (Biller/Insurance Follow-Up Representative at Lehigh Valley HospitalPatient Account Representative (Biller/Insurance Follow-Up Representative at Lehigh Valley Hospital