Billing specialist

Amanda Gallegos

Albuquerque, NM • 505-***-**** • ********@*****.***•

Professional Summary

Revenue Cycle & Operations Management Professional with comprehensive experience managing full-cycle medical billing, claims adjudication, and medical office workflows. Proven record of untangling complex accounts receivable, lowering denial rates, and coordinating cross-functional teams to protect cash flow and compliance. Combines extensive healthcare administrative expertise with operational leadership to optimize daily logistics, documentation integrity, and patient account management.

Core Competencies

Revenue Cycle Management: Full-Cycle Billing, Insurance Verification, Claims Submission & Adjudication, Denial & Appeals Management

Accounts Receivable: Aging A/R Recovery, Payment Posting, Dispute Resolution, Payer/Adjuster Negotiations

Operations & Administration: Front-Office Coordination, Schedule Optimization, Records Compliance, Vendor Relations

Tools & Systems: Electronic Health Records (EHR/EMR), Medical Practice Management Software, Google Workspace, MS Office (Excel)

Professional Experience

MEDICAL BILLING SPECIALIST Infectious Disease & Internal Medicine Clinic Albuquerque, NM 2025 – Present

Direct end-to-end medical billing and revenue cycle operations, processing high-volume commercial and government insurance claims with a 98%+ clean-claims submission rate.

Manage aging accounts receivable (A/R) over 30/60/90 days, auditing patient ledgers, submitting corrected claims, and securing reimbursement on complex disputed accounts.

Conduct root-cause denial analysis, liaising directly with insurance adjusters and payer representatives to resolve pre-authorization and coding discrepancies.

Ensure strict adherence to HIPAA guidelines, payer policies, and clinical documentation requirements across all submitted appeals.

PATIENT VISIT SPECIALIST – RHEUMATOLOGY Presbyterian Healthcare Services Albuquerque, NM 2023 – 2025

Orchestrated daily patient intake, registration, and specialist scheduling for a high-volume outpatient rheumatology clinic.

Verified insurance coverage, obtained prior authorizations for specialized treatments, and collected patient copayments and deductibles at time of service.

Served as key administrative liaison between clinical staff, providers, and billing teams, resolving scheduling bottlenecks and front-end claim documentation errors.

EXECUTIVE ADMINISTRATIVE ASSISTANT Kinesio Holding Corporation Albuquerque, NM 2022 – 2023

Provided executive-level operational and administrative support, managing calendars, corporate communications, and high-level reporting workflows.

Coordinated vendor relationships, monitored departmental supply budgets, and implemented digitized file-tracking systems to boost cross-departmental efficiency.

OFFICE MANAGER / ADMINISTRATIVE LEAD ABQ Behavioral Services Albuquerque, NM 2021 – 2022

Directed front-office administrative procedures, onboarding schedules, and billing documentation support for multidisciplinary care teams.

Streamlined patient record workflows, reducing missing documentation delays and speeding up claim processing timelines.

Earlier Experience (Summary)

Medical Assistant New Mexico Osteoporosis and Research Center (2021 – 2022): Clinical support, patient intake, vitals tracking, and administrative documentation.

General Operations Manager Retail Operations (Prior): Directed daily store operations, employee scheduling, inventory logistics, and cash management.

Certifications & Credentials

Basic Life Support (BLS) / CPR – American Heart Association

Phlebotomy Certification

Assisting with Medication Delivery (AMD) – New Mexico State Certification.

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