Hi, I’m
RUBILYN REYES
Project Manager / Healthcare Professional / Research Assistant
Belleville,NJ
Work Preference
Summary
Dedicated and results-driven Healthcare Billing and Patient Access Specialist with over 15 years of extensive experience in Medicare Part B, DME, and infusion billing, as well as long-term care and assisted living reimbursement. Proven ability to manage high volumes of claims while effectively resolving denials and enhancing revenue cycle efficiency. Expertise in insurance verification, collections, and client outreach ensures compliance with CMS, HIPAA, and payer regulations. Committed to optimizing patient access and driving improvements in financial outcomes within healthcare environments.
Overview
26
years of professional experience
1
Certification
Work History
Generation Pharmacy Group
Billing Supervisor and Collections Specialist Long Term Care / Assisted Living Facility
2000.01 - 2017.08 (17 education.years_Label & 7 education.months_Label)
Job overview
- Supervised and performed billing and reimbursement operations for multiple assisted living and long-term care facilities, ensuring accuracy and compliance with Medicare Part B, Medicaid, and private insurance requirements.
- Processed and submitted DME and infusion billing claims, verified eligibility, and managed denials, rejections, and appeals.
- Oversaw collections and reconciliation of claims, correcting coding discrepancies to improve payment turnaround and cash flow.
- Ensured audit-ready documentation and adherence to CMS and HIPAA compliance standards.
- Trained billing staff in claims processing, documentation requirements, and compliance procedures.
- Conducted outreach with facility administrators, nurses, and family members to resolve billing issues, explain account details, and coordinate payment arrangements.
GeriScript Pharmacy
Billing & Collections Specialist Long Term Care / Assisted Living Facility
2000.01 - 2017.08 (17 education.years_Label & 7 education.months_Label)
Job overview
- Supervised and performed billing and reimbursement operations for multiple assisted living and long-term care facilities, ensuring accuracy and compliance with Medicare Part B, Medicaid, and private insurance requirements.
- Processed and submitted DME and infusion billing claims, verified eligibility, and managed denials, rejections, and appeals.
- Oversaw collections and reconciliation of claims, correcting coding discrepancies to improve payment turnaround and cash flow.
- Ensured audit-ready documentation and adherence to CMS and HIPAA compliance standards.
- Trained billing staff in claims processing, documentation requirements, and compliance procedures.
- Conducted outreach with facility administrators, nurses, and family members to resolve billing issues, explain account details, and coordinate payment arrangements.
- Concurrent
Partners Pharmacy
Billing Supervisor Long Term Care / Assisted Living Facility
2000.01 - 2017.08 (17 education.years_Label & 7 education.months_Label)
Job overview
- Supervised and performed billing and reimbursement operations for multiple assisted living and long-term care facilities, ensuring accuracy and compliance with Medicare Part B, Medicaid, and private insurance requirements.
- Processed and submitted DME and infusion billing claims, verified eligibility, and managed denials, rejections, and appeals.
- Oversaw collections and reconciliation of claims, correcting coding discrepancies to improve payment turnaround and cash flow.
- Ensured audit-ready documentation and adherence to CMS and HIPAA compliance standards.
- Trained billing staff in claims processing, documentation requirements, and compliance procedures.
- Conducted outreach with facility administrators, nurses, and family members to resolve billing issues, explain account details, and coordinate payment arrangements.
- Concurrent
Thermo Fisher Scientific / Bristol-Myers Squibb
Regional Lead Service Support Representative / Client Outreach Specialist
2022.04 - 2025.12 (3 education.years_Label & 8 education.months_Label)
Job overview
- Served as Subject Matter Expert overseeing 5,000+ lab instruments across GxP and non-GxP facilities.
- Lead client outreach and follow-up to ensure satisfaction, timely issue resolution, and proactive communication.
- Coordinated laboratory maintenance, calibration, and service requests using CMMS systems.
- Managed vendor relationships, purchase orders, and preventive maintenance scheduling.
- Generated reports and analyze service data for performance and compliance.
- Key Achievement: Improved service turnaround and client satisfaction through proactive outreach and workflow tracking.
Hackensack Meridian Health Pharmacy
Patient Access & Billing Coordinator
2021.06 - 2022.04 (10 education.months_Label)
Job overview
- Prepared and submitted Medicare Part B and DME claims for infusion therapy in long-term and assisted living settings.
- Verified eligibility and documentation to ensure CMS compliance.
- Tracked denials and outstanding claims, coordinating corrections and rebills.
- Conducted outreach with patients, families, and facilities to resolve billing and authorization issues.
Option Care Health
Intake & Infusion Billing Specialist
2020.09 - 2021.06 (9 education.months_Label)
Job overview
- Managed DME and infusion billing for Medicare Part B patients in home and LTC settings.
- Processed insurance verifications, prior authorizations, and infusion documentation.
- Serviced and prepared IV pumps before and after use, ensuring accuracy and compliance.
- Followed up on denied or underpaid claims; coordinated with payers and clinical teams.
Newark Beth Israel Medical Center
Patient Access Specialist / Research Coordinator (Transplant Department)
2017.08 - 2020.08 (3 education.years_Label)
Job overview
- Verified insurance eligibility and obtained prior authorizations for specialty and transplant services.
- Educated patients on coverage, co-pay assistance, and reimbursement options.
- Collaborated with providers and case management to ensure payer compliance and continuity of care.
Monarc Bionetworks
Clinical Research Coordinator / Patient Access Liaison
2018.05 - 2019.08 (1 education.year_Label & 3 education.months_Label)
Job overview
- Supported patient onboarding and eligibility verification for clinical research programs.
- Coordinated patient communication, visit scheduling, and sponsor documentation.
- Ensured GCP and HIPAA compliance in study and data management.
Education
Pharmacy Technician Certification Board
Certified Pharmacy Technician (CPhT)
Medical Training InstituteBloomfield, NJ
University Overview
Coursework in Nursing
Essex County CollegeNewark, NJ
University Overview
Coursework in Nursing
Skills
- Experience with LTC framework implementation
- DocuTrack
- CPR
- QS1
- RX30
- Epic
- KloudScript
- Power BI
- 3M
- Microsoft Office
- Maximo
- ServiceChannel
- Workday
- EHR / EMR
- CRM Systems
Certification
National Board of Pharmacy Technician Certification
CORE COMPETENCIES
- Medicare Part B & DME Billing
- Infusion & LTC Billing
- Assisted Living Reimbursement
- Insurance Verification & Authorization
- Denials & Appeals
- Collections & A/R Management
- Client Outreach & Relationship Management
- Compliance (CMS, HIPAA, Medicaid)
- HCPCS / CPT Coding
- Documentation & Audit Readiness
- CMMS & Billing Systems
HIGHLIGHTS OF QUALIFICATIONS
- 15+ years of experience in Medicare Part B, DME, and infusion billing for LTC and assisted living facilities.
- Expertise in client outreach, patient access, and reimbursement resolution.
- Skilled in collections, A/R, and compliance auditing with CMS and HIPAA standards.
- Proven success by improving claim accuracy and revenue cycle efficiency.
Languages
English
Full Professional
Filipino
Full Professional
Timeline
Regional Lead Service Support Representative / Client Outreach Specialist
Thermo Fisher Scientific / Bristol-Myers Squibb
2022.04 - 2025.12 (3 education.years_Label & 8 education.months_Label)
Patient Access & Billing Coordinator
Hackensack Meridian Health Pharmacy
2021.06 - 2022.04 (10 education.months_Label)
Intake & Infusion Billing Specialist
Option Care Health
2020.09 - 2021.06 (9 education.months_Label)
Clinical Research Coordinator / Patient Access Liaison
Monarc Bionetworks
2018.05 - 2019.08 (1 education.year_Label & 3 education.months_Label)
Patient Access Specialist / Research Coordinator (Transplant Department)
Newark Beth Israel Medical Center
2017.08 - 2020.08 (3 education.years_Label)
Billing Supervisor and Collections Specialist Long Term Care / Assisted Living Facility
Generation Pharmacy Group
2000.01 - 2017.08 (17 education.years_Label & 7 education.months_Label)
Billing & Collections Specialist Long Term Care / Assisted Living Facility
GeriScript Pharmacy
2000.01 - 2017.08 (17 education.years_Label & 7 education.months_Label)
Billing Supervisor Long Term Care / Assisted Living Facility
Partners Pharmacy
2000.01 - 2017.08 (17 education.years_Label & 7 education.months_Label)
Medical Training Institute
Essex County College
Pharmacy Technician Certification Board
Certified Pharmacy Technician (CPhT)