Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Sandra Macias

San Antonio,3122 Carswell Bend

Summary

A position as a Treatment Coordinator where I can be able to fully utilize my professional experience.

Results-driven insurance professional with comprehensive experience in claims collection and resolution. Strong analytical skills and adept at negotiating settlements and navigating complex billing systems. Known for exceptional team collaboration and adaptability in fast-paced environments. Dependable and focused on achieving outcomes that drive organizational success.

Insurance professional with proven track record in managing account collections and resolving disputes efficiently. Known for strong focus on team collaboration and achieving results, with flexible approach to changing needs. Proficient in negotiation and maintaining meticulous financial records, fostering reliability and trust among colleagues.

Experienced with managing insurance collections and efficiently resolving outstanding balances. Utilizes effective negotiation skills and communication to facilitate payment arrangements and account resolution. Strong understanding of financial record-keeping and compliance with industry regulations.

Knowledgeable Collection with solid background in managing insurance collections and resolving outstanding accounts. Successfully coordinated with clients and internal teams to ensure timely payment and account resolution. Demonstrated proficiency in negotiating payment arrangements and maintaining accurate financial records.

Skilled professional with experience in collections, customer service and data entry. Exceptional interpersonal and problem-solving skills. Effectively mediates customer disputes and collects payment in timely manner.

Competent Accounts Receivable Specialist bringing 20 years of experience handling accounts receivable functions. Exemplary skill in resolving billing disputes, providing excellent customer service and applying payments. Recognized for effective leadership with consistent achievement of objectives.

Thorough team contributor with strong organizational capabilities. Experienced in handling numerous projects at once while ensuring accuracy. Effective at prioritizing tasks and meeting deadlines.

Dynamic individual with hands-on experience in patient collection and talent for navigating challenges. Brings strong problem-solving skills and proactive approach to new tasks. Known for adaptability, creativity, and results-oriented mindset. Committed to making meaningful contributions and advancing organizational goals.

Possesses versatile skills in project management, problem-solving, and collaboration. Brings fresh perspective and strong commitment to quality and success. Recognized for adaptability and proactive approach in delivering effective solutions.

Experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, ensuring high standards, and aligning efforts with organizational goals. Known for collaborative approach and commitment to excellence.

Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level collection position. Ready to help team achieve company goals.

Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise.

Tech-savvy innovator with hands-on experience in emerging technologies and passion for continuous improvement. Skilled in identifying opportunities for technological enhancements and implementing effective solutions. Adept at leveraging new tools and methods to solve problems and enhance productivity. Excels in adapting to fast-paced environments and driving technological advancements.

Demonstrates strong analytical, communication, and teamwork skills, with proven ability to quickly adapt to new environments. Eager to contribute to team success and further develop professional skills. Brings positive attitude and commitment to continuous learning and growth.

Overview

19
19
years of professional experience

Work History

Insurance Collector

SmileBrands
San Antonio, TX
01.2006 - 2017
  • Trace unpaid dental claims for general & specialty insurance
  • And Denti-Cal.
  • Process insurance denials and resubmissions and provide thorough accurate denial information.
  • Build relationship with field operations and insurance plans.
  • Adjudicate insurance payments and reconcile with system.
  • Insurance adjustments (time filing, non-contract provider, and transfer to patient, ect.).
  • Retrieve reports from Oracle Apex/Excel.
  • Audit insurance aged receivables on office reporting suite to resolve aging buckets oldest to newest.
  • Audit zero dollars expect claims to ensure process is functioning properly and open claims match to the insurance balance.
  • Audit and resolve unusual or challenging open claim issues.
  • Front desk
  • Administrative duties (e.g. answering phones, scheduling appointments, billing PPO’s & HMO’s plans, billing general and orthodontics, tracing claims, generating encounter forms, audit charts).
  • Treatment Counselor with strong communication skills with patients
  • Financial arrangements and calculation of treatment amounts, offered to patients Care Credit, payment plans, set up automatic debit withdrawals and payment arrangements.
  • Conformation and estimate of insurance benefit and limitations, financial breakdown of treatment plan
  • Expose and developed dental x-rays.
  • Recruit New Dentists
  • Credential Doctors for HMO and PPO plans
  • Team lead
  • Conduct weekly meetings with staff, address conflict (between team members) and help to resolve the matter in a professional manner.
  • Managed insurance billing collections
  • Supervised and direct insurance productivity, assigned work, providing expectations and guidelines, and monitor performance.
  • Assisted with posting checks on a timely matter

Insurance Collection Specialist

River City Dental Solution
San Antonio, Texas
04.2020 - 06.2025
  • Managed insurance collections through timely follow-ups and documentation.
  • Analyzed customer accounts to identify outstanding balances and potential disputes.
  • Developed payment plans tailored to client needs, enhancing collection rates.
  • Collaborated with cross-functional teams to resolve billing discrepancies efficiently.
  • Trained new staff on collection procedures and compliance regulations.
  • Implemented process improvements that streamlined workflows and reduced errors.
  • Provided exceptional customer service, addressing inquiries and concerns promptly.
  • Monitored industry trends to adapt strategies for effective debt recovery initiatives.
  • Collaborated with cross-functional teams to address discrepancies and ensure accurate billing information.
  • Ensured accurate data entry by meticulously reviewing all claim submissions before sending them to insurance companies for processing.
  • Provided excellent customer service by addressing inquiries from both clients and insurance providers in a timely manner.
  • Established positive working relationships with key stakeholders such as attorneys, medical professionals, and adjusters to expedite claim resolutions.
  • Leveraged strong communication skills to negotiate settlements with delinquent account holders while maintaining professionalism and courtesy at all times.
  • Increased departmental productivity by implementing best practices in workflow management based on industry benchmarks.
  • Negotiated favorable payment terms, resulting in prompt settlements of overdue accounts.
  • Mitigated risk exposure by conducting thorough audits of client accounts for signs of fraud or other discrepancies.
  • Reduced aged receivables with diligent follow-up on outstanding insurance claims.
  • Monitored insurance payment trends, identifying potential issues and proactively addressing them to prevent future delays in payments.
  • Assisted in developing new policies and procedures to enhance overall team performance.
  • Responded to customer inquiries and provided detailed account information.
  • Maintained accurate records of customer accounts, payments and payment plans.
  • Monitored customer accounts for payment delinquency and initiated collection efforts.
  • Contacted customers to discuss past-due accounts and negotiated payment plans.
  • Worked with customer to create debt repayment plan based on current financial condition.
  • Established relationships with customers to encourage payment of delinquent accounts.
  • Listened to customers and negotiated solutions that met creditor and debtor needs.
  • Processed debtor payments and updated accounts to reflect new balance.
  • Entered client details and notes into system for interdepartmental access and review.
  • Researched billing errors and discrepancies to initiate corrective action.
  • Located customers with overdue accounts and solicited payment in compliance with fair debt collection practices.
  • Generated and distributed monthly customer statements.
  • Investigated customer credit references and approved credit lines.

Auditor

DDS River City Dental Solutions/ River City Better Sleep
01.2020 - 01.2025
  • Resolve months of backlogged deposits and adjustments, researched and solved dental billing problems with patient charts and accounts, audit and resolve unusual or challenging open claim issues and unbalance accounts, perform adjustments and corrections.
  • Tracking dental claims with insurance companies, appeal and resubmission of claims.

Auditor

DDS Dentures Implants Solutions Central Business/Front Office
01.2017 - 01.2020
  • Resolve months of backlogged deposits and adjustments, researched and solved dental billing problems with patient charts and accounts, audit and resolve unusual or challenging open claim issues and unbalance accounts, perform adjustments and corrections.
  • Tracking dental claims with insurance companies, appeal and resubmission of claims.

Auditor

Smile Care Corporation SA CBO
01.2006 - 01.2017
  • Resolve months of backlogged deposits and adjustments, researched and solved dental billing problems with patient charts and accounts, audit and resolve unusual or challenging open claim issues and unbalance accounts, perform adjustments and corrections.
  • Tracking dental claims with insurance companies, appeal and resubmission of claims.
  • Process referrals for in-house plan.

Education

High School Diploma -

Grant High School
North Hollywood, CA
01.1999

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San Fernando Valley College
01.2000

Skills

  • Strong customer service/ telephone skills
  • Good communication skills (written and verbal)
  • Knowledge of billing for general, ortho and specialty for HMO’s PPO plans and Medicaid
  • Knowledge in electronic billing; Claim Connections and NEA
  • Audit Claims & Charts
  • Knowledge in dental terminology and ADA codes
  • Knowledge of dental plans (HMO,PPO), Discount plans, Medicaid)
  • Recruiting and Contracting Doctors
  • Ability to read radiographs
  • Software Knowledge in QSI, Excel, Microsoft Outlook, Liberty Eaglesoft Version
  • Bilingual- English/Spanish
  • Teamwork
  • Organization skills
  • Debt collection expertise
  • Data entry proficiency
  • Follow-up techniques
  • Teamwork and collaboration
  • Customer service
  • Problem-solving
  • Time management
  • Attention to detail
  • Problem-solving abilities
  • Multitasking
  • Updating customer accounts
  • Multitasking Abilities
  • Reliability
  • Excellent communication
  • Clear communication
  • Organizational skills
  • Team collaboration
  • Active listening
  • Effective communication
  • Adaptability and flexibility
  • Verbal and written communication
  • Debt settlement
  • Data entry skills
  • Creative problem solving
  • Decision-making
  • Relationship building
  • Payment scheduling
  • Microsoft office
  • Documentation and recordkeeping
  • Documentation skills
  • Professional ethics
  • Negotiation and resolution
  • Team building
  • Analytical and critical thinking
  • Task prioritization
  • Work Planning and Prioritization
  • Self motivation
  • Interpersonal skills
  • Client relationship management
  • Customer relationship management
  • Conflict resolution
  • Accurate payment posting
  • Computer literacy
  • Goal setting
  • Risk assessment
  • Problem identification
  • Account monitoring
  • Professionalism
  • Account reconciliation
  • Training and teaching
  • Investigative research
  • Payment processing
  • Record keeping
  • General ledger
  • Continuous improvement
  • Paperwork processing
  • Billing procedures
  • Payment management
  • Data analysis
  • Managing delinquent accounts
  • Cash application
  • Skip tracing
  • Payment solicitation
  • Insurance company communication
  • Word processing

Languages

Spanish
Full Professional

Timeline

Insurance Collection Specialist

River City Dental Solution
04.2020 - 06.2025

Auditor

DDS River City Dental Solutions/ River City Better Sleep
01.2020 - 01.2025

Auditor

DDS Dentures Implants Solutions Central Business/Front Office
01.2017 - 01.2020

Insurance Collector

SmileBrands
01.2006 - 2017

Auditor

Smile Care Corporation SA CBO
01.2006 - 01.2017

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San Fernando Valley College

High School Diploma -

Grant High School