Medical Billing Revenue Cycle

Professional Summary

Detail-oriented and bilingual Billing & Collections Specialist with extensive experience in insurance underwriting, medical billing, claim processing, and revenue cycle management. Proven ability to assess risks, manage provider credentialing, and ensure compliance with industry regulations. Adept at using EPIC, Jet File, Microsoft Office Suite, Report Writer, and Crystal PM to optimize workflows. Strong communication and negotiation skills with a track record of enhancing operational efficiencies and maximizing reimbursement. Fluent in English and Spanish.

Key Skills & Competencies

Insurance Underwriting & Risk Assessment

Medical Billing & Revenue Cycle Management

Insurance Credentialing & Contracting

Claims Processing, Reimbursement & Appeals

Regulatory Compliance (Medicare, PECOS, State & Federal Insurance)

Client & Broker Relations

Electronic Medical Records (EMR) & Practice Management Software

Microsoft Office Suite, EPIC, Jet File, Crystal PM

Bilingual: English & Spanish

Customer Service & Relationship Management

Lead Generation & Sales Support

Professional Experience

Lady B Production (Now Santana Lifestyle Properties) – Remote

Billing & Client Relations Specialist 9/2023 – Present

• Managed billing operations, lead generation, and client relations to drive business growth.

• Reviewed contracts to ensure compliance and accuracy, coordinated sales processes, and maintained strong client relationships.

• Provided administrative support, optimized workflow efficiency, and contributed to business expansion.

• The company has since transitioned into Santana Lifestyle Properties, specializing in Caribbean real estate.

London Aviation Underwriters – Federal Way, WA

Aviation Service Underwriter 04/2022 – 08/2023

• Assessed aviation risk factors (aircraft type, pilot experience, regulatory compliance) to develop tailored policies.

• Negotiated insurance terms, risk mitigation strategies, and policy renewals with brokers and clients.

• Ensured compliance with aviation and insurance industry regulations while minimizing

financial risk.

• Reviewed and advised on insurance claims to verify adherence to policy terms.

Noble Eyes & Vision Center – University Place, WA

Billing Coordinator 04/2019 – 04/2022

• Managed end-to-end billing processes for two optometry offices, including insurance eligibility verification, benefit authorization, and claim submission.

• Oversaw insurance credentialing & contracting, adding providers and locations to existing contracts.

• Processed insurance payments, balanced accounts, and worked on claim denials/appeals via online portals.

• Ensured compliance with Medicare, PECOS, and private insurance policies.

Southlake Clinic – Renton, WA

Patient Account Representative II 06/2014 – 11/2019

• Managed insurance reimbursement, claim rejections, and appeals across private and government payers.

• Researched and resolved unpaid claims, EOB discrepancies, and reimbursement issues.

• Processed corrected claims, insurance follow-ups, and revenue cycle adjustments.

• Maintained HIPAA compliance and provided exceptional customer service to patients, providers, and insurers.

Education & Certifications

• Insurance Producer – Property & Casualty Washington State (2023)

• BA in Business Administration University of Nevada, Reno (1985)

• C+ Certified Computer Networking & Microsoft Windows Professional 2000

Computer Education Institute – Carson, CA (2002)

Professional Tools & Technology

• EMR & Billing Software: EPIC, Crystal PM, Jet File

• Practice Management: Microsoft Office Suite, Report Writer

• Communication & Collaboration: Zoom, Google Meet

Hobbies & Interests

Animal Lover & Advocate

Passionate about Environmental Issues & Waste Management

Supporting Sustainable Practices & Green Initiatives

References available upon request.

Contact this candidate