Office & Billing Specialist with Bilingual Skills
Resume:
SUSANA RODRIGUEZ
**************@*****.***
Phone
Seeking a position in an office environment, where there is a need for a variety of office tasks including computer knowledge, credentialing, medical scheduling and billing, and behavioral health.
Bilingual in both Spanish and English
Work Experience
Aug 2025-Feb 2026
Care Navigator (Remote), Referwell
Tucson, AZ.
Managed a high-volume caseload of ~150-175 cases, facilitating timely referrals and scheduling to improve patient access to care.
Increased referral show rates by providing empathetic, proactive outreach and addressing patient barriers to care.
Closed referral loops by following up with specialists to retrieve consultation notes, ensuring 100% accurate, real-time documentation.
Utilized CRM tools to track member engagement and identify patients with high-risk gaps in care.
Dec 2020 - Feb 2025
Administrative Assistant/Revenue Cycle Specialist/Credentialing Specialist, Sondercare Behavioral Health
Tucson, AZ
●Greet visitors, ascertain purpose of visit, and direct them to appropriate staff.
●I have 3 to 5 years of previous experience in medical billing/collections in a medical/behavioral health office, clinical site, or billing/collections office.
●Knowledge in payment posting through EHR software.
●Post Electronic Remittance Advices (ERAs), as assigned, and check any rejected payments and verify that all payments posted. Make any necessary corrections to posting.
●Ensures that all payments received are accurately posted for end of month balancing.
●Knowledge of HIPAA Privacy and Security rules.
●Knowledge of billing practices and medical/behavioral health office policies and procedures.
●Demonstrate ability to interpret patient accounts.
●Maintains required billing records, reports, files, etc. according to protocol.
●Complete site and provider enrollment and re-validation applications with insurance companies and accrediting entities.
●Communicate credentialing status to practices and leadership to prevent billing delays.
●Knowledge of credentialing paperwork and timelines.
●Organizing daily work assignments for various providers.
●I have worked with multiple EHR software and have built EHR software.
●Demonstrates understanding of Payer fee schedules and enrollment requirements.
●Knowledge of medical/behavioral health terminology, CPT codes and ICD-10.
●Experience with filing UB-04 and HCFA 1500 claim form.
●Experience with all aspects of credentialing process; NPPES, PECOS.
●Medicare and/or Medicaid knowledge.
Mar 2018 - Mar 2020
Office Manager/ Medical Records, Evolved
Tucson, AZ
●Develop work schedules according to budgets and workloads.
●Compile and record medical charts, reports, or correspondence, using personal computer.
●Organization and Attention to Detail.
●Consult with managers or other personnel to resolve problems in areas such as equipment performance, output quality, or work schedules.
●Discuss work problems or grievances with union representatives.
●Monitor inventory levels and requisition or purchase supplies as needed.
Mar 2017 - Mar 2018
Front Desk Receptionist/Medical Records, Raad Taki Plastic Surgery Center
Tucson, AZ
●Compile and record medical charts, reports, or correspondence, using personal computer.
●Answer phones, greet clients, and provide general office support.
●Enter and update client information in databases with high accuracy.
●Organize and maintain digital records, ensuring easy retrieval and security of documents
Mar 2016 - Mar 2017
Front Desk Receptionist, Western Gastroenterology
Tucson, AZ
●Receive and route messages or documents, such as laboratory results, to appropriate staff.
●Answer phones, greet clients, and provide general office support.
●
●Assist with scheduling closings and coordinating with internal staff and external parties.
●Support office workflow and assist team members as needed.
●Interview patients to complete documents, case histories, or forms, such as intake or insurance forms.
Feb 2009 - Nov 2015
Referral and Prior Authorization Specialist, Chiricahua Medical Center
Douglas, AZ
●Schedule tests or procedures for patients, such as lab work or x-rays, based on physician orders.
●Identify if prior authorization is required; initiate and follow through with insurance companies or review organizations to obtain approvals.
●Communicate directly with physicians, clinical departments, payers, and patients to address authorization issues, delays, or denials.
Education
High School Diploma or Equivalent, General Studies.
Douglas High School, Douglas, AZ
Licenses and Certifications
CPR/First Aide
●Tucson Fire Department
Level I Fingerprint Clearance Card
●Department of Public Safety
Telecommuting Requirements:
Ability to keep all company sensitive documents secure (if applicable).
I have a dedicated work area established that is separated from other living areas and provides information privacy.
I live in a location where I can receive approved high-speed internet connection or leverage an existing high-speed internet service.
Contact this candidate