Detail-Oriented Healthcare Billing Specialist with 20+ Years

PROFESSIONAL

SUMMARY

WORK HISTORY

EDUCATION

CERTIFICATIONS

SANDRA VERGARA

■ Maricopa, AZ 85138 ■ 305-***-**** ■ ******.*******.**@*****.*** ■ Adaptable and detail-oriented professional with 20+ years of healthcare billing and claims experience. Skilled in customer support, problem-solving, and mentoring, with proven success in streamlining processes and ensuring accuracy. Bilingual in English and Spanish, proficient in remote collaboration tools, and eager to apply transferable skills to entry-level opportunities in medical billing, customer service, or new fields. Known for reliability, clear communication, and a commitment to learning and growth.

SKILLS • Claims Processing & Insurance Knowledge • Customer Service & Support Medical Terminology & Coding (ICD-10,

CPT, HCPCS)

• • Remote Collaboration (Zoom, Teams)

• Auditing & Compliance (HIPAA) • Training & Mentoring

• Communication & Problem-Solving • Adaptability & Flexibility SENIOR CLAIMS ANALYST 07/2004 to 05/2025

Vitas Healthcare Corporation, Miami, FL

Processed and resolved high-volume claims with 98% accuracy, ensuring timely payments and compliance.

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• Identified coverage limitations and discrepancies, reducing claim denials by 15%. Supported audits by preparing thorough documentation and explanations, strengthening compliance standards.

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Led cross-functional initiatives that improved claims efficiency, cutting processing time by 20%.

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Mentored and trained junior analysts, fostering team development and consistent performance.

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MEDICAL CODING AND BILLING SPECIALIST 06/2003 to 07/2004 Phymed Inc, Miami, FL

Reviewed and verified medical documentation to ensure accuracy and compliance with billing regulations, reducing claim errors.

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Processed insurance claims using ICD-10, CPT, and HCPCS coding systems, achieving consistent accuracy and efficiency.

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Maintained strict patient confidentiality by adhering to HIPAA regulations throughout all coding and billing activities.

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No Degree : Medical Billing And Coding, 01/2004

National School of Technology - Miami, FL

• Licensed Insurance Producer - Accident, Health, Life - 2025 LANGUAGES English

Native or Bilingual

Spanish

Native or Bilingual

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