Healthcare Systems Specialist
HELLO, WELCOME HOLA, BIENVENIDO
ABOUT ME
Dedicated professional with years of exemplary experience in investigating and analyzing medical financial accounts; wishes to transition into the information technology field; highly driven, very organized, love a challenge, very dependable, great attention to detail and have plans in place to obtain certifications as soon as possible. I am looking for a position that will help me further my career in both healthcare and information technology.
MY EXPERIENCE
Roles & Responsibilities
ACCOUNT MANAGER / SPECIALIST
January 2022 - April 2023
Provided resolution services for several healthcare organizations.
✪ Resolved complex payment denials by correcting errors and supplying additional information required for collections of payments and any additional reimbursement due to the clients.
✪ Keep current with all commercial and managed care pricing or fee schedule models, rules and regulations
✪ Reviewed remittances to ensure correct reimbursement and reported any trends, issues and payer trends.
✪ Documented findings in clear and concise manner in multiple systems for each client.
✪ Participated in educational opportunities and training to gain stronger knowledge in industry updates and federal regulations to better serve my assigned clients.
✪ Increased certain client revenues by approximately 50%, 3 months after on-boarding, through steady collaboration with upper management and client administrators.
ACCOUNT MANAGER, STAFFING AGENCIES
January, 2006 - April 2021
Provided financial services on a temporary basis for various top-tier healthcare organizations.
✪ Processed data with mainframes and system computers.
✪ Increased and maintained knowledge of ICD-9 coding and Medicaid guidelines.
✪ Managed billing and collections efforts and participated in account analysis projects.
✪ Processed customer orders and returns and responded to customer queries.
✪ Performed account analyst and medical billing functions for various companies across California.
✪ North County Health Services, DJO Global, UC San Diego Medical Center, Palomar Pomerado Health, and Rady Children’s Hospital.
ACCOUNT SPECIALIST / SYSTEMS SUPPORT, AK BILLING SOLUTIONS
July 2018 - December 2019
Developed long-term relationships with a portfolio of clients.
✪ Ensured the timely and successful delivery of our solutions according to customer needs.
✪ Communicated progress of monthly/quarterly initiatives to numerous clients.
✪ Liaised between the clients and internal teams.
✪ Supported wide range of remotely hosted Desktop applications.
✪ Assisted in analysis of database management solutions.
✪ Installed and trained the staff in the use of the new software applications.
SR. ACCOUNT SPECIALIST / HIPAA OFFICER, ACCELERATED REVENUE MANAGEMENT
July 2014 - June 2018
Managed A/R data analysis and reporting, and audited compliance of billing.
✪ Ensured HIPAA compliance and coordinated with IT on application processing.
✪ Maximized cash flow by resolving A/R issues, and improved customer relationships.
✪ Served as first line of support to users and diagnosed technical issues.
IT SUPPORT TECHNICIAN, OPTIMISCORP
July 2014 - January 2017
Maximized computer systems capabilities by studying technical applications; made improvement recommendations.
✪ Achieved computer system objectives by gathering data, identifying and evaluating options, recommending system changes.
✪ Maximized use of hardware and software by training users; interpreting instructions; and answering technical questions.
ACCOUNT ANALYST / SR VERIFICATION ANALYST, NAVIGANT CYMETRIX
January 2007 - December 2011
Ensured accuracy and reconciliation of cash receipt batches.
✪ Posted and applied patient and third-party payments to cash receipt modular.
✪ Researched and resolved discrepancies for third-party claims.
✪ Collaborated with Billing Department to research and resolve A/R issues.
✪ Implemented upgraded systems applications.
✪ Saved $500k and received numerous IMAGE Awards for exemplary service.
✪ Managed team of 4 analysts in maintaining departmental databases for accurate, timely, thorough documentation.
✪ Mastered verification consistency in payment terms of contracts.
TECH SUPPORT SPECIALIST, THE SOCIAL PLACE
January 2006Â - December 2007
✪ Installed and configured computer systems and applications within the company
✪ Responded to customer inquiries and assist in troubleshooting and resolving challenges
✪ Actively updated, maintained and monitored computer networks
✪ Resolved technical issues related to network interruptions
✪ Attended client meetings to analyze, troubleshoot and diagnose hardware problems
✪ Maintained a detailed log on all required system updates, as well as the date of completion
✪ Organized and filed documentation for warranties and instructional guides for computer hardware
✪ Assisted in creating training materials pertaining to computers and troubleshooting
EDUCATION
My Studies
LONG BEACH STATE UNIVERSITY
Bachelor of Science - Health Care Administration
Focus and concentration on Health Care Management, legal aspects of health care, financial management, marketing, economics, information systems, quality management, health system analysis and evaluation, operations management, technology ethics, and society.
ITT TECH - VISTA
Bachelor of Science - Network Systems Administration
Focus and concentration on network hardware, software maintenance and monitoring, configuring and supporting a local area network (LAN) and a wide area network (WAN), Internet systems and segments of network systems.
MY SKILLS
Tricks of the Trade
COMMUNICATION
A Valuable Skill
COMPUTER SKILLS
Above and Beyond
FINANCIAL ANALYSIS
Raising the Bar
ORGANIZATIONAL
Purpose Driven
ADAPTABILITY
Essential Flexibility
WORK ETHIC
Strong