Summary
Overview
Work History
Education
Skills
References
Timeline
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Sandra De Los Santos

Pearland,TX

Summary

Committed and results-oriented professional willing to go above and beyond to contribute to team objectives. Highly skilled in collections with much success at resolving disputes and billing inquiries. Comfortable working independently or as part of supportive team.

Overview

8
8
years of professional experience

Work History

A/R Collection Specialist/Surgery Scheduling Coordinator

Plaza Ob/gyn Associates & Binz Weight Loss Center
Houston, TX
04.2023 - Current
  • Wrote appeal letters to insurance companies for denial of claims.
  • Processed claims and forwarded information to Medicare, Medicaid and commercial insurance companies.
  • Worked with insurance companies to ensure timely reimbursement of claims.
  • Generated reports in order to track payments due from insurance companies or other third party payers.
  • Researched discrepancies between billed charges and payments received from insurance companies or other third party payers.
  • Collaborated with other hospital personnel to coordinate resources for optimal patient flow during surgery scheduling processes.
  • Coordinated with patients, staff, and physicians to ensure accurate scheduling of surgeries.
  • Processed payments from patients for surgical services rendered.

Revenue Cycle Specialist

South Belt Medical Center
Houston, TX
04.2021 - 04.2023
  • Processed appeals related to denied or rejected claims in a timely manner.
  • Maintained current knowledge of insurance policies, procedures, regulations, and guidelines.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Processed corrections and adjustments as needed to ensure accurate payment from third party payers.
  • Resolved denied claims by researching payer requirements and preparing appeals.
  • Identified trends in denials and worked collaboratively with clinic staff to reduce denials.

Demographics Team Lead

Win & Associates Medical Billing Services
Pearland, TX
05.2016 - 03.2021
  • Maintained patient accounts by obtaining, recording and updating personal and financial information.
  • Delivered high-quality administrative and customer service to sustain patient and work flows.
  • Compiled and coded patient information or data in appropriate computer system.
  • Entered insurance and demographics into patient database.
  • Performed data entry tasks related to billing and collections procedures.
  • Trained new staff on office procedures, insurance processes and medical terminology.
  • Managed office phone lines by checking voicemail, returning calls and directing messages to team members.
  • Answered incoming calls, responding to inquiries from patients and other medical offices.

Education

Some College (No Degree) -

San Jacinto College District
Pasadena, TX

Remington College
Webster, TX

Skills

  • Goal-Oriented
  • HIPAA Compliance
  • Insurance Verification
  • Adjustment Posting
  • Payment Processing
  • Microsoft Office
  • Revenue Cycle Management
  • Claims Processing

References

References available upon request.

Timeline

A/R Collection Specialist/Surgery Scheduling Coordinator

Plaza Ob/gyn Associates & Binz Weight Loss Center
04.2023 - Current

Revenue Cycle Specialist

South Belt Medical Center
04.2021 - 04.2023

Demographics Team Lead

Win & Associates Medical Billing Services
05.2016 - 03.2021

Some College (No Degree) -

San Jacinto College District

Remington College

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Sandra De Los Santos