Rayenon Ross
Houston,TX
Summary
Detail-oriented professional with a strong focus on enhancing patient financial experiences. Known for effective communication and problem-solving skills, fostering relationships with patients and insurance vendors to ensure timely account resolutions.
Overview
22
22
years of professional experience
Work History
Senior Patient Account Services-RCM
Altus Biologics
Pearland, TX
12.2022 - 09.2025
- Communicated with patients, clients, and insurance vendors in a professional and respectful manner. Work closely with patients to resolve billing and payment issues.
- Handled inbound calls and assist patients with account inquiries. Performed research and analysis of account issues and strives to resolve problems timely and accurately.Performed medical collection activities including follow-up and account resolution.
- Handled inbound patient and/or carrier calls promptly and professionally, providing assistance and resolution to account.
- Meet daily productivity and quality standards.
- Performed other special projects as required when assigned.
- Document and update patient account information in the collection system.
- Process payments and refunds.
- Communicate with insurance companies to obtain prior authorizations and verify coverage.
- Follow up on unpaid claims and denials.
- Collaborate with other departments to improve processes and ensure timely reimbursement.
- Maintain knowledge of current insurance regulations and coding requirements.
Revenue Cycle Manager-Patient Service Manager
Nobilis Healthcare
Houston, TX
11.2017 - 01.2019
- Manages and oversees business office functions in records, accounting, billing, accounts payable, and accounts receivable, inventory and supply management. Ensures all bills are paid in a timely and accurate manner.
- Quality Reporting for Medicare Compliance.
- Developing a New Department, Training Employee while implementing Plans, Policies and Procedures for billing and Patient collections for 6 Ambulatory Surgical Centers and 4 Hospitals. Responsible for large Accounts Receivables of $10,000,000-$20,000,000 per Center.
- Revenue Cycle Management: Coordinated efforts across all departments to decrease billing errors and increased revenue, working closely with billing & collections to determine opportunities for improvement.
- Developed and introduced plans and policies that reduced bad debt, charity, and collection costs.
- Specializing in Out of Network Payer and In Network Payer.
- Manage the entire patient billing and collections lifestyle, including registration, insurance verification, claims submission, and payment processing, which may include performance analysis, recruiting, and training.
- Track key metrics, such as coding error rates and billing turnaround times, and generate reports to identify financial opportunities. Act as a single point of contact for clients, address concerns, and ensure that performance metrics and contractual obligations are met.
- Recruit, train, and evaluate customer service representatives. Monitor and analyze response times and service quality to identify areas for improvement.
Healthcare Administrator
Nobilis Healthcare
Houston, TX
06.2013 - 11.2017
- Managed the Non Clinical day-to-day operations of 2 healthcare facilities or specific department in Houston, TX and Scottsdale, AZ. Set and implement facility policies, goals, and procedures, ensuring compliance with state and federal regulations.
- Manages administrative tasks and staff within a medical office. Ensuring the facility is prepared for emergencies.
- Hiring, training, and supervising clinical staff, creating work schedules, and conducting performance reviews.
- Evaluate staff performance and provide coaching, feedback, and accountability Lead weekly 1:1s, attend monthly leadership meetings, and participate in off-site quarterly team gatherings.
- Maintaining records of the facility's services.
- Communicate and implement updated policies and procedural changes.
- Ensure customer service excellence and handle patient concerns with empathy and professionalism.
- Serve as the first point of contact for all office-related issues and coordinate with upper management.
- Manage supply ordering, inventory tracking, and monthly facility audits.
- Monitor clinic cleanliness, organization, and building maintenance needs.
Collection Specialist
Houston Orthopedic Surgical Hospital
Bellaire, TX
05.2010 - 06.2013
- Medical Billing and Collections for a large Orthopedic Surgical Hospital. Specializing in Commercial Payer, such as BCBS and Cigna.
- Facilitated meetings with CFO of insurance billing company to resolve issues, outstanding receivables and collections.
- Responsible for large Accounts Receivables of $5,000,000-$10,000,000.
- Responsible for training Physicians staff on Practice Management Software and office procedures.
- Handle escalated or complex claim denials and discrepancies, research issues, and take necessary actions to resolve them.
- Analyze denial trends, identify problem areas, and report findings to management for strategic action.
- Reviewing billing information, identifying and correcting coding or billing errors from EOBs (Explanation of Benefits), and processing claim rejections.
- Submit and follow up on medical claims to insurance providers and other payers. Handle claim denials and resubmit corrected claims. Ensure accuracy in coding, including diagnosis and procedure codes, before submitting claims. Maintain billing systems and prepare billing reports.
Medical Billing and Collections Consultant
Ayers Medical Consultants
Houston, TX
10.2008 - 05.2010
- Consults with Physician to review and analyze billing, claims, and payment processes to identify inefficiencies and revenue leaks.
- Recommend and implement strategies to streamline the revenue cycle, from patient scheduling and insurance verification to claim submission and collections. Conduct training for employees on best practices for billing and patient relations.
- Research, analyze, and help resolve complex claim denials from insurance providers by preparing appeal letters and updating account information.
- Ensure accurate billing to insurance providers and patients, including proper coding, and help maintain up-to-date knowledge of coding systems and payer policies.
- Build and maintain financial models, conduct root cause analysis, and use data analytics to assess performance.
- Trained and educated staff on new processes, best practices, and software to improve billing accuracy and efficiency.
- Monitored accounts receivable, oversee monthly reporting, and conduct regular audits of billing records to ensure accuracy and identify areas for improvement.
- Acted as a technical resource, communicating with clients, directors, managers, and staff to address inquiries and collaborate on solutions.
- Created and implement policies and procedures to enhance operational efficiency and performance.
Account Receivable Manager
Texas Rheumatology Center
Sugar Land, TX
08.2007 - 10.2008
- Created and Implemented Billing Department.
- Created policies and procedures.
- Increased income by correct coding and HIPPA Guidelines.
- Responsible for Billing and collections, appeals and posting of payments for 2 physicians, 1 Physicians Assistant. I was able to collect 60% of the A/R over 120 days.
- Managed large Account Receivables ranging from $200,000 to $500,000 for IV Infusion clinics.
Billing/Collections Manager
Clearlake Neurology, PLLC
Houston, TX
03.2004 - 08.2007
- Responsible for all hospital charge entry and physician billing.
- Responsible for collection on accounts, appeals and posting of payments for 3 physicians.
- Collected 75% of A/R over 120 days. Responsible for all financial aspects, including deposits and reporting.
Education
Certification in Medical Office Management -
Concorde Career Institute
Houston, TX12.1991
Skills
- Revenue cycle management
- Customer relationship management
- Data analysis
- Account reconciliation
- Training development
- Account resolution
Timeline
Senior Patient Account Services-RCM
Altus Biologics
12.2022 - 09.2025
Revenue Cycle Manager-Patient Service Manager
Nobilis Healthcare
11.2017 - 01.2019
Healthcare Administrator
Nobilis Healthcare
06.2013 - 11.2017
Collection Specialist
Houston Orthopedic Surgical Hospital
05.2010 - 06.2013
Medical Billing and Collections Consultant
Ayers Medical Consultants
10.2008 - 05.2010
Account Receivable Manager
Texas Rheumatology Center
08.2007 - 10.2008
Billing/Collections Manager
Clearlake Neurology, PLLC
03.2004 - 08.2007
Certification in Medical Office Management -
Concorde Career Institute