Sergio Villarreal
Chula Vista
Summary
Detail-oriented Billing Specialist with proven skills in denial management, claims submission, and revenue cycle management. Expertise in insurance verification and prior authorizations, ensuring timely reimbursements and enhanced patient satisfaction.
Overview
20
20
years of professional experience
Work History
Billing Specialist
Fusion Care Group
Mission Valley
03.2024 - Current
- Denial Management & Appeals
- Managed insurance claims submissions and follow-ups, ensuring timely reimbursements.
- Processed mental health claims, achieving accurate billing and compliance.
- Mental Health Billing & Collections
- Denial Management & Appeals
- Claims Submission & Follow-Up
- Revenue Cycle Management
- Insurance Verification & Benefits
- Executed payment posting and reconciliation, maintaining account accuracy.
- Behavioral Health CPT Codes
- Prior Authorizations
- EOB & ERA Review
- Patient Account Resolution
- Medicaid, Medicare & Commercial Insurance
- Excel & Reporting
- HIPAA Compliance
- Customer Service & Patient Communication
Revenue Cycle Specialist
Sharp Healthcare
San Diego
12.2019 - 07.2024
- Processed and corrected medical claims for hospital and outpatient services, ensuring accurate reimbursement.
- Followed up on claims and resolved denials, contributing to timely payments.
- Verified insurance eligibility and corrected claim edits.
- Collaborated with insurance companies to address reimbursement issues and manage appeals effectively.
- Assisted patients with billing and insurance-related questions.
Health Center Supervisor
Planned Parenthood
Los Angels
11.2006 - 07.2010
- Led daily healthcare operations and supervised staff to ensure efficient service delivery.
- Conducted coaching sessions and daily huddles to communicate workflow updates and organizational goals.
- Provided feedback and guidance to staff and medical providers.
- Promoted patient satisfaction and effective team leadership by modeling best practices.
- Assisted with hiring, onboarding, and employee disciplinary actions.
- Approved and corrected payroll timesheets.
- Managed inventory ordering and supply oversight.
- Provided coverage for staff during breaks to ensure continuous workflow and quality patient care.
- Assisted with medical billing and front office operations.
Education
High School Diploma -
Castle Park High
Chula Vista 06-2003
Skills
- Denial management
- Claims submission
- Revenue cycle management
- Insurance verification
- Prior authorizations
- Customer relationship management
- IMS
- SimplePractice
- EPIC
- Microsoft Excel
- Microsoft Teams
- Payspan
- Carelon
- RingCentral
- EMR/EHR Systems
- Revenue Cycle Management Systems
Timeline
Billing Specialist
Fusion Care Group
03.2024 - Current
Revenue Cycle Specialist
Sharp Healthcare
12.2019 - 07.2024
Health Center Supervisor
Planned Parenthood
11.2006 - 07.2010
High School Diploma -
Castle Park High