Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Edubina N Saenz

Bakersfield

Summary

Dynamic Billing Specialist with extensive experience at Lincare and PPS adept at resolving billing discrepancies and enhancing customer satisfaction. Proven track record in claims processing and HIPAA compliance, leveraging strong problem-solving skills to optimize revenue retention. Recognized for meticulous attention to detail and effective communication, driving successful outcomes in complex billing environments.

Overview

15
15
years of professional experience

Work History

Billing Specialist/Senior Collections Representative

Bolthouse
08.2023 - 08.2025
  • Researched and resolved billing discrepancies to enable accurate billing.
  • Identified, researched, and resolved billing variances to maintain system accuracy and currency.
  • Worked with multiple departments to check proper billing information.
  • Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
  • Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
  • Collaborated with the collections team to recover overdue payments from clients, maintaining cash flow and minimizing writeoffs.
  • Maintained detailed records of each account''s payment history, providing easy access to information for audit and analysis purposes.
  • Reduced errors in financial records by conducting regular audits of billed accounts.
  • Enhanced customer satisfaction with timely and accurate invoice generation.
  • Maintained up-to-date knowledge of billing regulations and compliance requirements, ensuring adherence to legal standards.

Medical Billing\Collections

Townsend Design
07.2021 - 08.2023
  • Maximized revenue potential by identifying and resolving under-billed accounts.
  • Ensured compliance with industry regulations by staying up-to-date on changes in billing rules and guidelines.
  • Strengthened client relationships through effective communication regarding billing issues and concerns.
  • Enhanced accuracy in patient billing through meticulous record-keeping and verification of insurance details.
  • Proactively addressed potential billing discrepancies by conducting pre-billing audits.
  • Negotiated with insurance companies to resolve disputed claims, securing rightful payments.
  • Implemented cost-saving measures by identifying and eliminating inefficiencies in billing process.
  • Increased revenue retention by setting up follow-up system for outstanding payments.
  • Reduced billing errors, leading to decrease in customer complaints, by conducting regular audits of billing data.
  • Optimized payment collection times by implementing effective follow-up strategies with clients.
  • Improved customer satisfaction with prompt and clear communication regarding their billing inquiries.
  • Handled account payments and provided information regarding outstanding balances.

Billing and Collections Specialist

Lincare Healthcare
01.2016 - 06.2021
  • Responded to customer requests for products, services, and company information.
  • Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
  • Developed strong product knowledge to provide informed recommendations based on individual customer needs.
  • Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
  • Managed difficult conversations with compassion and professionalism, helping deescalate tense situations while maintaining a focus on finding resolutions.
  • Increased first-call resolution rates by carefully listening to customers'' needs and providing accurate information based on their inquiries.
  • Expanded knowledge on medical terminology and insurance policies through continuous learning initiatives, enhancing accuracy in communication with clients.
  • Reduced claim denials by diligently reviewing patient records for correct coding and billing information.
  • Prevented unnecessary loss of revenue due to late or incomplete billing by meticulously tracking all accounts and ensuring timely submission of accurate claim forms.
  • Maintained excellent relationships with insurance representatives to expedite claims processing and secure timely reimbursements for services rendered.
  • Increased overall collection rates with a focus on reducing aged receivables and minimizing writeoffs.
  • Managed high-volume payment processing tasks, consistently meeting deadlines without compromising accuracy or quality.
  • Monitored outstanding balances, following up on overdue payments to minimize loss or delay in revenue collection.
  • Utilized Microsoft Excel, QuickBooks and Oracle software to manage invoices and payments.
  • Monitored accounts to verify compliance with payment terms and schedules.

Medical Billing Coordinator

Pacific Pulmonary Medical Group
12.2010 - 01.2016
  • Leveraged strong organizational skills to maintain comprehensive patient accounts, enabling quick access to relevant information during billing inquiries.
  • Maintained detailed knowledge of various payer requirements, facilitating smoother interactions between healthcare providers and insurance companies during claims processing efforts.
  • Improved billing accuracy by implementing stringent quality control measures and enhancing documentation processes.
  • Enhanced patient satisfaction with clear communication of payment expectations, resolving concerns, and providing flexible payment options.
  • Safeguarded sensitive patient data through strict adherence to HIPAA guidelines and implementation of secure record-keeping practices.
  • Coordinated with clinical teams to ensure proper documentation was received for accurate coding and claim submissions, reducing delays in reimbursements.
  • Effectively resolved disputes regarding coverage eligibility or claim denials through professional communication with patients and insurance representatives alike.
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Verified insurance of patients to determine eligibility.
  • Posted payments and collections on regular basis.
  • Collected payments and applied to patient accounts.
  • Liaised between patients, insurance companies, and billing office.
  • Delivered timely and accurate charge submissions.
  • Responded to customer concerns and questions on daily basis.
  • Collaborated with customers to resolve disputes.

Education

High School Diploma -

Bakersfield High School
Bakersfield

Skills

  • Billing systems and software

  • Insurance verification

  • Customer service

  • Claims processing

  • HIPAA compliance

  • Claim submission

  • Payment posting

  • Customer engagement

  • Patient account management

  • Relationship building

  • Record preparation

  • Problem-solving

  • Attention to detail

  • Multitasking and organization

  • Dispute resolution

  • Medical coding

  • Billing software proficiency

  • Medical billing and collections

Languages

Spanish
Full Professional

Timeline

Billing Specialist/Senior Collections Representative

Bolthouse
08.2023 - 08.2025

Medical Billing\Collections

Townsend Design
07.2021 - 08.2023

Billing and Collections Specialist

Lincare Healthcare
01.2016 - 06.2021

Medical Billing Coordinator

Pacific Pulmonary Medical Group
12.2010 - 01.2016

High School Diploma -

Bakersfield High School

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Edubina N Saenz