Summary
Overview
Work History
Education
Skills
Timeline
Generic

Sandy Montes De Oca Garcia

Passaic

Summary

Results-driven Patient Account Representative with 1 plus year of direct patient billing and account support experience across multiple healthcare clients, backed by several years of remote customer service and call center experience across healthcare, eligibility, enrollment, and government program support. Skilled in reviewing patient accounts, explaining billing statements, explanation of benefits, updating insurance, verifying eligibility, assisting with payment arrangements, routing claims, CPT code, and charge review requests. Strong ability to improve patient and customer satisfaction through clear communication, de-escalation, accurate documentation, first-contact resolution, and HIPAA/PHI compliance.

Overview

4
4
years of professional experience

Work History

Patient Account Representative

Sutherland Healthcare Solutions
Remote
03.2025 - Current
  • Review patient accounts, statements, payment history, insurance activity, claim status, denials, adjustments, and account notes to determine next steps and explain billing concerns clearly.
  • Handle inbound and outbound calls for hospital and physician group clients, including balance, statement, payment, insurance, and billing questions.
  • Assisted patients with one-time payments, payment arrangements, portal navigation, and billing education while maintaining empathy and professionalism during escalated calls.
  • Verified and updated insurance information, reviewed eligibility responses, corrected payer sequencing, and routed account review requests for rebilling or billing team actions.
  • Review CPT code, charge, claim, denial, and billing-related concerns, then submit coding review or billing escalation requests to the appropriate team.
  • Documented patient interactions, account findings, actions taken, and follow-up needs accurately, ensuring compliance with HIPAA/PHI and quality standards.
  • Navigate Soarian Financials, Epic Guesthouse, Operator Portal, eCW workflow, Five9, and client-specific patient account procedures.

Customer Service Representative, Eligibility and Enrollment Support

Guidant Global
Remote
09.2024 - 01.2025
  • Provided eligibility and enrollment support for health coverage project, assisting callers with applications, benefits eligibility, policies, and enrollment inquiries.
  • Managed 40+ inbound calls daily while maintaining professionalism, empathy, accuracy, and clear communication in a remote call center environment.
  • Reviewed customer information, clarified program requirements, guided next steps, and escalated unresolved eligibility or account issues for further review.
  • Maintained 95% to 100% quality assurance performance by following compliance standards, documenting interactions accurately, and resolving concerns efficiently.

Customer Service Representative, Government Program Support

Conduent Business Services
Remote
12.2021 - 08.2024
  • Provided application and account support for government benefit programs, including the Affordable Connectivity Program, SNAP, and Lifeline Program, ensuring customer understanding and access to resources.
  • Reviewed caller information, explained program requirements, processed requests, and documented account activity accurately, enhancing service consistency across multiple systems.
  • Handled high call volumes in a remote environment while providing clear, professional, and empathetic support to customers seeking benefit or program assistance.
  • Resolved escalations and customer concerns while ensuring compliance and accuracy, demonstrating strong problem-solving skills in high-pressure situations.

Education

High School Diploma -

Passaic High School
Passaic, NJ
07-2013

Certificate of Completion - Criminal Justice

Passaic County Community College
Passaic, NJ

Skills

  • Interpersonal skills and teamwork
  • Service orientation
  • Patient account management
  • Claim review and requests
  • Billing support and payment arrangements
  • Charge review and escalations
  • Account reconciliation
  • Insurance updates
  • Attention to detail
  • EOB inquiries
  • Patient-focused resolution strategies
  • Systems proficiency

Timeline

Patient Account Representative

Sutherland Healthcare Solutions
03.2025 - Current

Customer Service Representative, Eligibility and Enrollment Support

Guidant Global
09.2024 - 01.2025

Customer Service Representative, Government Program Support

Conduent Business Services
12.2021 - 08.2024

High School Diploma -

Passaic High School

Certificate of Completion - Criminal Justice

Passaic County Community College
Sandy Montes De Oca Garcia