Maria Medina-Andrade
Aurora
Summary
Dynamic Billing Specialist with extensive experience, excelling in claims denials management and revenue cycle analysis. Proven track record in improving clean claim rates through effective SOP development and cross-functional communication. Expertise in Medicare and Medicaid policies, complemented by strong training abilities to enhance team performance and compliance.
Overview
12
12
years of professional experience
2
2
Certifications
Work History
Medical Billing Specialist
Apex Paramedics
01.2025 - Current
- Managed high-volume ambulance and healthcare claims across Medicare, Medicaid, workers’ compensation, and commercial payers with precise charge entry and coding accuracy.
- Performed detailed claims audits, corrected coding errors, applied modifiers, and ensured documentation supported billed services.
- Filed claims electronically, manually, through payer portals, and by paper when required.
- Specialized in Medicaid and Medicare policy navigation, including coverage rules, documentation needs, and reimbursement variances.
- Investigated denials and wrote complex appeals, reconsiderations, and dispute letters to overturn incorrect payer decisions.
- Expert in clearinghouse rejection analysis, error resolution, and resubmission strategies to improve clean claim rates.
- Collaborated with facilities, providers, and insurance carriers to resolve discrepancies and correct account data.
- Created staff training materials, SOPs, and payer reference guides to improve team accuracy and compliance.
- Trained new staff on billing systems, payer rules, and proper completion of claims to reduce future denials.
Revenue Cycle Analyst
Independent Contractor
09.2023 - 01.2025
- Conducted full-cycle revenue cycle assessments, analyzing charge capture, coding, claim submission, payment posting, and A/R workflows for multiple clients.
- Identified trends in payer denials, underpayments, coding issues, and documentation gaps; implemented corrective action plans.
- Designed dashboards and reports tracking claim status, denial categories, reimbursement variances, and productivity.
- Standardized documentation workflows, insurance verification processes, and charge entry accuracy to improve clean claim rates.
- Developed payer-specific SOPs, training programs, and compliance guides used by billing and clinical teams.
- Trained revenue cycle staff on appeals, reconsiderations, payer rules, clearinghouse rejections, and accurate claim completion.
- Collaborated cross-departmentally to support operational transitions and revenue cycle improvement initiatives.
Supervisor, Health Information Management
UCHealth
02.2020 - 09.2023
- Ensured accuracy, completeness, and compliance of medical records through QA audits, documentation checks, and corrective coding requests.
- Processed record amendments, release of information (ROI), and coding-related updates with high precision.
- Audited chart quality to support accurate downstream billing, coding, and claim submission.
- Created SOPs improving documentation accuracy, coding workflows, and PHI compliance.
- Trained HIM staff on regulatory standards, documentation integrity, and record correction procedures.
- (Medical Records Expertise Supporting Billing & Documentation Integrity)
Supervisor, Patient Access
UCHealth
06.2015 - 02.2020
- Oversaw insurance verification, prior authorization workflows, demographic accuracy, and financial clearance.
- Identified and corrected account errors impacting billing, coding, and reimbursement.
- Managed workflows for incomplete clinical data and registration errors to reduce downstream claim denials.
- Developed training on insurance rules, Medicare MSP guidelines, coordination of benefits, and patient registration accuracy.
- (Insurance Knowledge
- Data Entry
- Pre-Registration
- Front-End RCM)
Manager, Patient Access
Adeptus Health
06.2013 - 06.2015
- Trained staff on insurance processes, patient intake accuracy, and documentation requirements.
- Ensured regulatory compliance and clean data entry supporting accurate billing and timely reimbursement.
- Improved workflows through data analysis, reporting, and process redesign.
Education
Certificate - Certified Professional Coder (CPC)
AAPC
01-2026
Certificate - Certified Professional Biller (CPB)
AAPC
12-2025
Associate of Arts - Psychology
Red Rocks Community College
Golden, CO01.2015
Skills
- Medical billing and coding
- ICD-10 and CPT
- HCPCS modifiers
- Medicare and Medicaid expertise
- Claims denials management
- Appeals and reconsiderations
- Clearinghouse rejection handling
- Manual claim filing
- Revenue cycle analysis
- A/R follow-up strategies
- Charge entry evaluation
- Billing accuracy assurance
- Medical records review
- HIM compliance oversight
- Insurance verification processes
- Eligibility determination
- EPIC proficiency
- Avality and Waystar usage
- ZirMed navigation
- Medicaid portal management
- SOP development and optimization
- Process improvement strategies
- HIPAA compliance adherence
- PHI protection measures
- Cross-functional communication
Certification
Lean Six Sigma - Green Belt
Timeline
Medical Billing Specialist
Apex Paramedics
01.2025 - Current
Revenue Cycle Analyst
Independent Contractor
09.2023 - 01.2025
Supervisor, Health Information Management
UCHealth
02.2020 - 09.2023
Supervisor, Patient Access
UCHealth
06.2015 - 02.2020
Manager, Patient Access
Adeptus Health
06.2013 - 06.2015
Certificate - Certified Professional Coder (CPC)
AAPC
Certificate - Certified Professional Biller (CPB)
AAPC
Associate of Arts - Psychology
Red Rocks Community College