Raylene Vasquez
Eisenhower Medical Center
BEAUMONT,CA
1
Language
12
years of professional experience
Detail-oriented Accounts Receivable Specialist with 11 years of experience in billing and collections. Skilled in claims processing, client communication, and reporting, resolving payment discrepancies and managing multiple projects efficiently. Expertise in payment posting through various channels to maintain current accounts, driving organizational growth.
Work History
Insurance Analyst II
8 Months- Evaluated coverage options, identifying potential gaps in patient policies and recommending adjustments.
- Analyzed insurance claims to ensure compliance with organizational policies and procedures.
- Managed commercial insurance, Medicare credits to ensure timely resolution of all accounts.
- Regularly analyze account inventory aged greater than 90 days to promote payment and resolution of all accounts in an effort to decrease AR days.
- Processed incoming hard copy explanation of benefits and reacted appropriately to resolve the accounts.
- Review new credit balance accounts every day and prepare adjustments or refunds to zero the account balance
- .Review denial, payor rejection, and any other necessary reports to determine strategy in decreasing payor denials, clearing house rejections and delayed payments
Accounts Receivable Specialist
1 Year 7 Months- Monitored accounts to ensure timely payments and promptly identified discrepancies, enhancing cash flow.
- Evaluated open accounts to look for past-due balances and pursue collection strategies.
- Investigated billing discrepancies to resolve concerns and prevent future problems.
- Investigated billing discrepancies to resolve concerns and implement solutions that prevent future issues.
- Demonstrated proficiency in various aspects of the revenue cycle.
- Evaluated open accounts for past-due balances and implemented collection strategies to recover outstanding funds.
- Ensured compliance with Medicare regulations and guidelines.
- proficiency in multiple areas of the revenue cycle.
Authorization Specialist
2 Months- Analyzed patient authorization requests, ensuring compliance with insurance guidelines and organizational policies.
- Assisted clients with accurate eligibility form, application and document completion.
- Coordinated with healthcare providers and insurance companies to expedite approval processes for medical services.
- Reviewed clinical documentation to assess medical necessity and align with payer requirements for authorization.
Accounts Receivable Specialist
8 Years 9 Months- Analyzed data to identify trends in claim problems, errors, and discrepancies, facilitating proactive resolution.
- Prepare and resubmit clean claims to various insurance companies including workers compensation.
- Gained familiarity with Medicare and Medicaid policies
- Researched all primary and secondary denied Insurance claims, Appealed denials, submitted authorizations.
- Reconcile past-due accounts within 24 hours
- Developed strategies that streamlined operational procedures and enhanced cost-effectiveness.
- Processed an average of 150 claims a day
- Processed payments, refunds and adjustments to customer accounts.
- Implemented efficient billing procedures, improving cash flow management across departments.
Education
Associate of Science - Medical Billing
Skills
CMS-1500 experience
UB04 experience
PT
OT
ST
subacute-SNF billing experience
Insurance follow-up
Billing procedures
Critical thinking
Internet applications
Strong knowledge of ICD-10
CPT and HCPC coding
Submitting multi-specialty claims to third-party payers
Strong knowledge of medical terminology and coding
Experience with internet applications
Raintree software
EPIC software
MS Office experience
Strong financial
mathematical and analytical skills
Medical terminology
Critical Thinking
and Problem Solving skills
Knowledge of managed care
Medicare/Medi-Cal Billing regulations
Languages
Spanish
Limited Working
Timeline
Insurance Analyst II
Eisenhower Medical Center
12.2025 - CurrentRead More
Accounts Receivable Specialist
Providence Health Care
03.2024 - 10.2025Read More
Authorization Specialist
VWI
12.2023 - 02.2024Read More
Accounts Receivable Specialist
Raintree Systems
10.2014 - 07.2023Read More
Westwood College - Denver North
Associate of Science from Medical Billing
Read More