Efficient Medical Billing Specialist with 7 years of experience in handling wide variety of medical billing and coding tasks. I am a Reliable and Detail-oriented individual with over 20 years of customer service and 6 years of Supervisor Experience. I also obtain excellent analytical and multitasking abilities, while being productive and diligent with passion for resolving discrepancies through attention to detail and creative problem-solving. Considered focused and organized team player with impeccable work ethic and drive.
Hi, I’m
Sindy Gonzalez
Camden,NJ
Summary
Overview
13
years of professional experience
Work History
Osborn Family Health Center
Medical Billing Specialist
01.2021 - Current
Job overview
- HIPAA Compliant
- Effectively manage billing processes for multiple insurance payors, ensuring accuracy and compliance with respective guidelines
- Submit claims to insurance carriers in a timely manner, meticulously adhering to submission requirements
- Post payments accurately to maintain up-to-date financial records
- Conduct a high volume of claim follow-up calls to insurance carriers, diligently researching and resolving account issues daily
- Demonstrate expertise in interpreting Explanation of Benefits (EOB) and RA's from insurance carriers, ensuring a comprehensive understanding for informed decision making
- Apply knowledge in Verification of Benefits, prior authorizations, concurrent reviews, and adeptly address and resolve insurance-related issues
- Possess an understanding of insurance cards, medical terminology, medical benefits, and proficiency in CPT/HCPCS and ICD-10 coding
- Follow up with insurance companies to confirm the receipt of documentation, and ensure the initiation and progress of prior authorizations and/or gap exceptions from contracted health plans
- Consult with clinical program to ensure that documentation for is complete for any insurance payment purposes, fostering collaboration between billing and clinical teams
- Support patients throughout the billing process
- Utilize tools and resources to provide accurate estimated reimbursements, offering well-informed policy recommendations to optimize revenue streams
- Appropriately document all correspondence with clients and third-party insurances, maintaining thorough and organized records to support accountability and transparency
- Other duties as required
PATHS LLC
Medical Billing Specialist
09.2018 - 01.2021
Job overview
- EPIC System Trained
- HIPAA Compliant
- Strongly Skilled within Outbound/ Inbound calls for Hospital, Physician, and Insurance Claims.
- Experience with Postíng and Tracking Payment.
- Able to Analyze Explanation of Benefits (EOBs) or Remittance Advice (ERA) and resubmit claims for payment from the appropriate insurance Carrier.
- Obtain General Knowledge of ICD-9/10, HCPCs, and CPT coding.
- Specialized in Resubmitting Medical Records and Hand- written Appeals for Payment within a Timely Manner.
- Obtained experience utilizing networks such as NJMMIS, Availity, NaviNet, Promise, United Health Care, Medicare, and other portals.
- Ability to Identify and resolve outstanding issues preventing claim resolutions to Correct and Resubmit claims for payment on Hospital and Physician bills within timely filing.
- Verified Health Insurance benefits and Authorizations for reprocessing of claims.
- Specialized in Anesthesia Billing which required me to add/remove Modifiers/Diagnosis codes for payment on reprocessed claims
Hudson Eyecare Associates
Optometrist Receptionist
05.2017 - 07.2018
Job overview
- Greets Patients and Schedules appointments over the telephone and in person, and provides patients with reminders through follow-up calls.
- Performed pre-tests to determine vision preliminaries and attach findings with patients’ files.
- Assist patients in choosing frames for eyeglasses and handling contact lenses.
- Contact vendors to maintain supplies of eyeglass frames and contact lenses before stock is low.
- Efficiently calculated bills and processed payments
- Gathered patient demographic and Verify patients’ insurance information and provide them with clarity on coverage and co-pays
- Light Billing experience
IHOP LLC
Lead Server/Crew Trainer
06.2011 - 03.2017
Job overview
- Manage daily restaurant operations with a focus on flawless execution to increase profit and enhance guest experiences.
- Assisted in Labor Scheduling, Crew Training and Certification.
- Manage reservations and seating arrangements efficiently. While also handling guest inquiries, comments, and complaints with professionalism.
- Monitor inventory levels and assist in placing orders for supplies.
- Ensured that all Companies Financial Quotas were met.
- Processed payments accurately for Cash handling/control.
Education
Strayer UniversityWashington, DC
BBA from Healthcare Management
06.2027
University Overview
- Dean's List [Spring and Summer of 2024]
- 3.6 GPA
Anthem Institute - New Jersey Cherry Hill, NJ
Certification from Medical Billing And Coding
03.2012
University Overview
Skills
- HIPAA Compliance
- Bilingual in Spanish and English
- Payment posting
- Claim submission
- Insurance Verification
- Data Entry
- Medical Terminology
- Critical Thinking
- Teamwork and Collaboration
- Accounts Receivable
- Oral and Written Communication
- Customer Service
- Organizational
- Problem-solving
- Detail Oriented
- Time Management
- Data Analysis
Languages
Spanish
Native or Bilingual
Timeline
Medical Billing Specialist
Osborn Family Health Center
01.2021 - Current
Medical Billing Specialist
PATHS LLC
09.2018 - 01.2021
Optometrist Receptionist
Hudson Eyecare Associates
05.2017 - 07.2018
Lead Server/Crew Trainer
IHOP LLC
06.2011 - 03.2017
Strayer University
BBA from Healthcare Management
Anthem Institute - New Jersey
Certification from Medical Billing And Coding
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