Summary
Overview
Work History
Education
Skills
Timeline
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Luis Menendez

Athens,GA

Summary

Dynamic Payment Resolution Specialist with Trinity Health, proficient at claims resolution and dispute mediations. Proven track record in analyzing complex data to drive effective solutions, ensuring compliance and enhancing customer relationships. Bilingual and dedicated, I excel in adapting to changing environments while maintaining professionalism and attention to detail.

Overview

20
20
years of professional experience

Work History

Payment Resolution Specialist

Trinity Health
Columbus , OH
05.2022 - Current
  • Worked with a variety of insurance companies including Blue Cross, Aetna, Cigna, United Healthcare in determining the root cause of claim denials. I also analyzed and reviewed claim denials for any payment trends.
  • Facilitated conference calls between various insurance companies involved in dispute resolution efforts in order to ensure the timely completion of claim processing and payment.

Billing & Follow up

Trinity Health
Columbus, OH
04.2020 - 05.2022
  • Due to Trinity changes and transitions, my employment position with St. Mary's was eliminated. I was able to learn about different areas of the revenue cycle, including billing, follow-up, and some denials. before I was placed on my permanent team on 05/12/22

Billing and Follow up Coordinator

St. Mary's Healthcare Systems
Athens, GA
09.2007 - 04.2020
  • Extensive knowledge in multiple managed care contracts. Able to navigate through them to solve various claim issues.
  • Ran reports and tracked collectors' productivity.
  • Worked with various agencies to facilitate successful collector follow-up.
  • Audit employees' productivity and quality performance.
  • Negotiated numerous single-case agreements with attorneys, other providers, and different vendors.
  • Able to meet provider goals and standards.
  • I was responsible for making sure the providers' high-dollar accounts were resolved according to contracts in a timely manner.

Collections Representative

Collection Services of Athens
Athens, GA
01.2005 - 11.2007
  • Collaborated with other departments to resolve disputes in a timely manner.
  • Contacted customers to discuss and resolve technical claim denials with payers.

Education

High School Diploma -

Freeport High School
Freeport
06.1998

Skills

  • Bilingual
  • Proficient in the revenue cycle process
  • Extensive knowledge of HCPCS and CPT codes
  • Proficient in Microsoft Suite and Excel
  • Adaptability to changing environments
  • Strong communication skills
  • Reliable

Timeline

Payment Resolution Specialist

Trinity Health
05.2022 - Current

Billing & Follow up

Trinity Health
04.2020 - 05.2022

Billing and Follow up Coordinator

St. Mary's Healthcare Systems
09.2007 - 04.2020

Collections Representative

Collection Services of Athens
01.2005 - 11.2007

High School Diploma -

Freeport High School

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Luis Menendez