Evita Gonzalez

Experienced Medical Billing Accounts Receivable Representative with proven success in full-cycle medical billing claims, follow up, denial resolution and revenue recovery.

Billing Specialist - DERMATOLOGY SPECIALISTS, INC

(2024-03 - 2026-03)

• Identified tends in rejections and escalated to manager for proactive resolution
• Reduced claim denial rate by 20% by identifying recurring issues and collaborating with coding staff
• Worked cross functionally with coding, registration, and patient access to resolve billing issues
• Monitored and exceed departmental KPIs including claim turnaround and denial rates

Revenue Cycle Manager / Billing Specialist - Sycuan Casino Resort

(2022-09 - 2023-12)

• Managed the Revenue Cycle team operations, including insurance verification, coding, charge entry, claims submission, collections, and payment posting.
• Served as the expert for verification, coding, billing, and collections processes.
• Developed and enhanced operating policies and procedures to improve quality and efficiency.
• Ensured compliance with coding and billing regulations, relevant healthcare regulations, and data privacy issues (e.g., HIPAA).
• Provided analysis, creating written processes and training others in implementing a cross functional revenue cycle team

Medical Billing Specialist Lead - Cognizant

(2018-07 - 2022-09)

• Charge entry
• Insurance eligibility and verification
• Reviewed and updated patient demographics
• Reviewed and worked various reports including aging, appeals, bad debt, collections

Medical Billing Specialist - San Diego Retina Associates

(2014-08 - 2018-07)

• Worked on accounts receivable (A/R), processed rejected claims, and performed necessary follow-up to ensure successful claim processing.
• Followed up on claims using various systems, including Nextech EHR, TriZetto clearinghouse, and others.
• Prepared and submitted clean claims to insurance companies electronically or by paper.
• Corrected and resubmitted claims to third-party payers when needed.
• Mailed appropriate patient contact letters to resolve outstanding claims.
• Maintained contact with other departments to obtain and analyze patient information for accurate billing documentation.
• Responded to patient inquiries and billing concerns via phone, email, and messaging portals.
• Performed follow-up calls and written correspondence to patients and payers as needed.

Bachelor of Arts - Healthcare Administration - University of Phoenix