Raymond Sanchez
Medical Billing / Collections
Sun Valley,CA
Overview
19
19
years of professional experience
Work History
Medical Collections Specialist
Avia Factoring
Toluca Lake, Ca
06.2020 - 03.2024
- Improved patient satisfaction by promptly addressing and resolving medical billing disputes.
- Conducted comprehensive audits of patient accounts periodically, identifying discrepancies requiring correction or further investigation.
- Negotiated payment plans with patients, ensuring timely payments and reducing financial strain on the practice.
- Implemented a more effective tracking system for unpaid balances, leading to faster resolution of overdue accounts.
- Assisted patients with understanding their financial responsibilities, easing concerns about complex medical bills.
- Monitored account receivables to identify trends and proactively address potential issues.
- Enhanced revenue recovery through diligent follow-up on delinquent accounts.
- Collaborated with insurance companies to expedite claims processing and secure timely reimbursements.
- Established clear expectations for payment arrangements, minimizing misunderstandings between patients and the practice.
- Updated patient records accurately to ensure seamless coordination between departments and minimize delays in treatment or billing.
- Maintained thorough knowledge of billing regulations, keeping the practice compliant with industry best practices.
- Reviewed aging reports regularly to prioritize collection efforts strategically based on account status and risk level.
- Managed high-volume caseloads effectively while maintaining strong attention to detail and accuracy in data entry tasks related to billing adjustments or chargeoffs.
- Logged charges and payments.
- Processed online and paper appeal submissions and refund requests.
- Processed billing calls and answered questions from patients and third-party carriers.
- Corrected, completed and processed claims for multiple payer codes.
- Researched billing errors and discrepancies to initiate corrective action.
Collection Customer Service Representative
Team Health West
Chatsworth, CA
09.2017 - 03.2020
- Streamlined the collections process for increased efficiency and reduced outstanding debts.
- Monitored account receivables to identify trends and proactively address potential issues.
- Enhanced revenue recovery through diligent follow-up on delinquent accounts.
- Collaborated with insurance companies to expedite claims processing and secure timely reimbursements.
- Updated patient records accurately to ensure seamless coordination between departments and minimize delays in treatment or billing.
- Maintained thorough knowledge of billing regulations, keeping the practice compliant with industry best practices.
- Reviewed aging reports regularly to prioritize collection efforts strategically based on account status and risk level.
- Managed high-volume caseloads effectively while maintaining strong attention to detail and accuracy in data entry tasks related to billing adjustments or chargeoffs.
- Logged charges and payments within Software.
- Processed online and paper appeal submissions and refund requests.
- Assisted in reconciling deposit and patient collections.
- Corrected, completed and processed claims for multiple payer codes.
- Processed billing calls and answered questions from patients and third-party carriers.
- Maintained accurate records of customer accounts, payments and payment plans.
- Monitored customer accounts for payment delinquency and initiated collection efforts.
- Researched billing errors and discrepancies to initiate corrective action.
- Entered client details and notes into system for interdepartmental access and review.
Medical Collections Specialist
Complete Infusion Care
Los Angeles, CA
03.2012 - 07.2017
- Managed high-volume caseloads effectively while maintaining strong attention to detail and accuracy in data entry tasks related to billing adjustments or chargeoffs.
- Worked closely with clinical staff to verify services rendered, enabling accurate coding and billing procedures.
- Maintained thorough knowledge of billing regulations, keeping the practice compliant with industry best practices.
- Reduced errors in billing documentation by implementing a rigorous quality control system.
- Conducted comprehensive audits of patient accounts periodically, identifying discrepancies requiring correction or further investigation.
- Streamlined the collections process for increased efficiency and reduced outstanding debts.
- Updated patient records accurately to ensure seamless coordination between departments and minimize delays in treatment or billing.
- Contributed to process improvements within the department, resulting in enhanced workflow efficiency and better overall performance metrics.
- Reviewed aging reports regularly to prioritize collection efforts strategically based on account status and risk level.
- Enhanced revenue recovery through diligent follow-up on delinquent accounts.
- Improved patient satisfaction by promptly addressing and resolving medical billing disputes.
- Monitored account receivables to identify trends and proactively address potential issues.
- Collaborated with insurance companies to expedite claims processing and secure timely reimbursements.
Medical Billing / Collections
Tower Outpatient Surgery
Los Angeles, CA
02.2005 - 02.2012
- Played an instrumental role in streamlining the collections process by implementing new procedures that resulted in improved outcomes for both patients and healthcare providers alike.
- Continually updated personal knowledge base regarding industry best practices, changes in coding guidelines, and advancements in medical billing technology to maximize revenue potential while maintaining strict adherence to ethical standards.
- Implemented efficient workflows within the department that led to increased productivity levels among staff members while reducing errors in claim submissions.
- Ensured compliance with industry regulations by staying up-to-date on changes to medical billing procedures and guidelines.
- Posted and adjusted payments from insurance companies.
- Filed and updated patient information and medical records.
- Located errors and promptly refiled rejected claims.
- Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Liaised between patients, insurance companies, and billing office.
- Monitored changes in payer requirements, adjusting billing practices accordingly to minimize disruptions in the revenue cycle.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Educated colleagues on best practices in medical billing, providing ongoing training sessions as needed.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Efficiently processed refunds or adjustments for patients when necessary, ensuring accuracy and compliance with company policies.
- Conducted regular audits of patient accounts for potential underpayments or overpayments due to incorrect coding or billing practices.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
- Reduced errors in medical billing by meticulously reviewing patient records and ensuring accurate coding.
- Collaborated closely with the clinical team to ensure proper documentation was obtained for accurate billing purposes.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Collected payments and applied to patient accounts.
- Maintained and updated collections tracking spreadsheet to help organize payment information.
- Precisely evaluated and verified benefits and eligibility.
- Participated in departmental meetings, sharing insights and ideas for improving overall medical billing efficiency and revenue generation.
- Pre-certified medical and radiology procedures, surgeries and echocardiograms.
- Prepared billing correspondence and maintained database to organize billing information.
- Verified insurance of patients to determine eligibility.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Posted payments and collections on regular basis.
- Delivered timely and accurate charge submissions.
- Monitored outstanding invoices and performed collections duties.
- Reconciled accounts receivable to general ledger.
- Responded to customer concerns and questions on daily basis.
Education
Diploma - Gen Studies
06.1985
Timeline
Medical Collections Specialist - Avia Factoring
06.2020 - 03.2024
Collection Customer Service Representative - Team Health West
09.2017 - 03.2020
Medical Collections Specialist - Complete Infusion Care
03.2012 - 07.2017
Medical Billing / Collections - Tower Outpatient Surgery
02.2005 - 02.2012
Garfield High School, Los Angeles - Diploma, Gen Studies