Summary
Overview
Work History
Education
Skills
Certification
References
Additional Expertise
Timeline
Generic

Stephanie Canisalez

San Antonio

Summary

Dynamic AR Manager with extensive experience at Pacific Neurobehavioral Clinic, excelling in revenue cycle management and credentialing. Proven track record in optimizing claims submission and enhancing customer satisfaction through effective communication. Skilled in CPT coding and staff training, driving operational efficiency and compliance in fast-paced environments.

Overview

16
16
years of professional experience
1
1
Certification

Work History

AR Manager/ Credentialer/ Verifier/Billing Manager

Pacific Neurobehavioral Clinic
San Diego
11.2019 - Current
  • Oversee the posting of charges and payments to ensure accuracy in financial transactions..
  • Verify insurance benefits and obtain authorizations for various medical services.
  • Handle billing and claims submission for workers' compensation and government/commercial insurance.
  • Conduct reconciliation of billing processes, ensuring proper revenue cycle management.
  • Generate reports for accounts receivable (AR) days to track outstanding balances and improve collections.
  • Perform credentialing for providers to ensure compliance with insurance networks.
  • Utilize coding expertise (CPT, ICD-10) to optimize reimbursement and reduce claim denials.
  • Interacted with customers via email, phone, or other communication channels to answer questions or resolve issues.
  • Monitored delinquent accounts and initiated collection efforts as needed.
  • Prepared monthly aging reports for review by management.
  • Ensured compliance with federal, state, and local regulations related to accounts receivable processes.
  • Assisted in month-end closing process, including account reconciliations, journal entries, and accruals.
  • Investigated and resolved customer inquiries regarding billing issues or discrepancies.
  • Researched disputed invoice items for resolution of payment delays.
  • Followed up with customers via phone, email, or mail regarding outstanding invoices.
  • Performed weekly audits of AR data entry accuracy for errors or omissions.
  • Negotiated payment plans with past due customers while ensuring full compliance with company policies.
  • Negotiated payment plans with delinquent accounts to maximize recovery rates.
  • Implemented effective billing procedures, reducing errors and improving customer satisfaction.
  • Ensured thetimely completion of credentialing processes by guiding providers on the required documentation.
  • Prepared correspondence for various departments concerning credentialing updates or requests for additional information.
  • Validated primary source documents such as licenses, diplomas, certifications and other related credentials.
  • Interacted regularly with representatives from health plans and commercial payers regarding credentialing matters.
  • Processed re-credentialing applications for existing providers according to contractual requirements.
  • Served as a resource person for staff members seeking assistance in understanding complex regulatory requirements related to provider enrollment processes.
  • Created monthly reports for senior management summarizing operational performance metrics.
  • Coached, mentored and trained team members in order to improve their job performance.
  • Conducted regular meetings with staff to discuss progress and identify areas of improvement.
  • Resolved customer complaints and issues promptly, maintaining a positive brand image.
  • Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
  • Checked documentation for appropriate coding, catching errors and making revisions.
  • Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.

Office Manager

Dr. Richard Blum
San Diego
07.2019 - 10.2021
  • Managed front desk operations including greeting visitors, answering questions or directing them to appropriate personnel.
  • Answered phone calls, responded to emails, routed mail and coordinated courier services.
  • Responded to customer inquiries via phone or email in a professional manner.
  • Maintained filing system for records, correspondence and other documents.
  • Handled scheduling and managed timely and effective allocation of resources and calendars.
  • Assisted in scheduling, rescheduling, and canceling appointments for patients.
  • Answered incoming calls from potential new patients and existing patient inquiries.
  • Conducted outbound calls to remind patients of upcoming appointments.
  • Inputted patient data into the electronic health record system.
  • Resolved conflicts between customers and staff in a professional manner.

Patient Financial Services Representative

Good Shepherd Health Care System
Hermiston
12.2016 - 05.2019
  • Followed up on insurance claims and patient accounts to ensure timely reimbursement.
  • Researched and resolved incorrect payments, EOB rejections, and outstanding claims.
  • Assisted patients in understanding financial assistance programs, Medicaid, and charity care options.
  • Managed patient registration, verified insurance coverage, and collected copays/deductibles.
  • Balanced cash drawer and established monthly payment plans for outstanding balances.
  • Participated in training sessions related to changes in laws and regulations affecting Patient Financial Services operations.
  • Managed collection efforts by working directly with patients on payment plans or arrangements that meet their needs while keeping within company guidelines.
  • Answered incoming calls from patients regarding billing inquiries and resolved customer service issues.
  • Handled credit card processing activities such as refunds, disputes, and chargebacks in accordance with applicable regulations.
  • Assisted in the maintenance of patient accounts to ensure accuracy of information including demographic, insurance and financial data.
  • Provided exceptional customer service by addressing patient concerns promptly and professionally.
  • Conducted follow-up on outstanding insurance claims and worked with other departments to resolve payment issues.
  • Contacted third party payers regarding unpaid claims or denied claims for further investigation and resolution.
  • Researched and responded to customer inquiries via phone, email, or mail regarding billing statements, services rendered.
  • Arranged debt repayment or established schedules for repayment based on customer's financial situation.
  • Negotiated credit extensions and waivers when necessary.
  • Wrote appeal letters to insurance companies for denial of claims.
  • Contacted insurance companies to check status of claim payments.

Accounts Receivable Specialist

Medical Management Headquarters
San Antonio
07.2011 - 11.2011
  • Managed aging reports for claims over 120 days and ensured timely follow-up.
  • Processed payments, entered adjustments, and handled patient billing inquiries.
  • Submitted HCFA 1500 and electronic claims while ensuring compliance with coding guidelines.
  • Communicated with insurance companies and providers regarding claim status and discrepancies.
  • Researched past due accounts and initiated collection efforts in a timely manner.
  • Reviewed and verified accuracy of invoices and account balances.
  • Responded promptly to customer inquiries regarding their account status or payment history.
  • Created reports on Accounts Receivable performance for management review.
  • Kept accounts receivable tracking database current with relevant client information, collection, and billing progress and program changes.
  • Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future problems.

Office Assistant/Referral Coordinator

Alamo Area Heart Rhythm
San Antonio
01.2010 - 06.2011
  • Obtained insurance authorizations.
  • Verified benefits and coordinated referrals for procedures and specialist visits.
  • Assisted with patient intake, including vital signs and medical history documentation.
  • Performed data entry tasks into various computer systems accurately and efficiently.
  • Provided administrative support to staff members, including copying and scanning documents, filing paperwork, and ordering supplies.
  • Organized office operations and procedures, such as managing calendars, scheduling appointments, preparing reports and maintaining records.
  • Answered incoming calls in a professional manner and directed callers to the appropriate personnel.
  • Maintained an organized filing system of paper documents and electronic files.
  • Organized files, developed spreadsheets, faxed reports and scanned documents to improve organizational workflow.
  • Assisted in the development and implementation of office policies and procedures.

Education

B.A.S. - Health Care Administration

Grand Canyon University
Phoenix, AZ
05-2024

Certification - Coding- CBCS

Med-Tech
11-2014

Certification - Computer Office Technology

Texas Careers
San Antonio, TX
07-2001

Skills

  • Certified Billing and Coding Specialist (CBCS) (2019 - 2025)
  • Epic, Medisoft, Meditech, AdvancedMD
  • Valant
  • Kareo
  • Payment negotiation
  • Staff training
  • Schedule preparation
  • Contract management
  • Revenue cycle management
  • Claims submission
  • Insurance verification
  • Workers' compensation and commercial insurance billing
  • CPT coding
  • ICD-10 coding
  • Accounts receivable
  • Financial reporting
  • Customer service
  • Credentialing & Compliance
  • Coaching and mentoring
  • Time management
  • Goal setting
  • Staff training and development
  • Revenue management
  • Financial management
  • Microsoft Office Suite (Word, Excel, PowerPoint)
  • Work prioritization
  • Verbal and written communication
  • Documentation and reporting
  • Customer relationship management (CRM)
  • Cross-functional teamwork
  • Policy and procedure development

Certification

  • CCS/CBC

References

References available upon request.

Additional Expertise

  • 10-Key by Touch, EMR Systems
  • Financial Reconciliation & Reporting
  • Payment Posting & Adjustments
  • HCFA 1500 & Electronic Claim Submission
  • Medical Terminology & Documentation
  • EHR

Timeline

AR Manager/ Credentialer/ Verifier/Billing Manager

Pacific Neurobehavioral Clinic
11.2019 - Current

Office Manager

Dr. Richard Blum
07.2019 - 10.2021

Patient Financial Services Representative

Good Shepherd Health Care System
12.2016 - 05.2019

Accounts Receivable Specialist

Medical Management Headquarters
07.2011 - 11.2011

Office Assistant/Referral Coordinator

Alamo Area Heart Rhythm
01.2010 - 06.2011

B.A.S. - Health Care Administration

Grand Canyon University

Certification - Coding- CBCS

Med-Tech

Certification - Computer Office Technology

Texas Careers

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Stephanie Canisalez