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Alejandro
Bilingual Operations & Medical Billing Specialist with 10+ years of experience
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Competencies
Prepared and submitted claims, verified insurance eligibility, and managed denials and appeals using various platform tools.
Implemented operational workflows, ensured compliance with standards like SOC 2 and ISO 27001, and trained staff on procedures.
Effectively communicated with clients, insurance companies, and team members in both languages to resolve issues and support team coordination.
Utilized EMR, CRM, Chartsquad, and other tools for data entry, record management, and workflow optimization.
Managed patient interactions, appointments, and inquiries ensuring high satisfaction and compliance with HIPAA protocols.
Education
Languages
Summary
Accomplished bilingual professional with extensive experience in medical billing, operations support, and client coordination. Skilled in streamlining workflows, managing teams, and ensuring regulatory compliance, with a proven ability to handle complex processes efficiently.
Key Achievements
- Managed billing data and claims submissions for medical procedures, ensuring 100% accuracy and timely reimbursements.
- Streamlined workflows with teams across multiple departments, reducing processing times by 25%, and trained 50+ staff on operational processes.
- Led a team of 25 agents in medical record retrieval, improving accuracy and reducing retrieval time by 20%, while maintaining full compliance with healthcare regulations.
Experience
Medical Insurance Biller
Prepare and submit medical claims and billing data to insurance companies using AmexOne, Availity, Optum Financial, and Optum Express., Verify patient insurance eligibility, referrals, and coverage; review patient information for accuracy and completeness., Code procedures using ICD-10 and apply...
Operations Support Specialist
Implemented operational processes and managed documentation to align with SOC 2, ISO 27001, and PCI DSS standards., Coordinated with IT and Customer Success teams to streamline workflows, reducing processing times by 25%., Supported data protection by reviewing vendor reports (e.g., Microsoft...
Switchboard Agent & Patient Coordinator
Managed 120+ daily calls and in-person interactions in Hollywood, Hialeah, and West Palm Beach, ensuring professional patient experiences., Executed appointment scheduling, insurance verification, and copayment collection with 100% accuracy using EMR systems., Updated patient records securely,...
CEO's Virtual Assistant
Provided executive-level operational support, managing communications and client inquiries with 25% efficiency improvement., Implemented data processes using CRM, enhancing stakeholder coordination., Documented operational procedures to support team goals in remote settings., Coordinated projects...
Global Operations Assistant (Freelance)
Supported teams of up to 110 advisors across 12 countries, managing client accounts and remote workflows., Trained 50+ staff on operational tools, increasing productivity by 25%., Coordinated cross-border operations, resolving logistical challenges with international stakeholders., Documented...
Senior Recruitment Specialist
Managed caregiver application processes, collecting documents and responding to 55+ daily inquiries., Reviewed and verified applicant documents, completing I-9 forms with 100% accuracy using InflowCare and HHAExchange., Scheduled orientations and trained 10+ new recruiters., Implemented new...
Team Leader
Led a team of 25 agents to achieve medical record retrieval goals., Oversaw data entry and retrieval using Chartsquad with 100% accuracy., Analyzed performance data, reducing retrieval time by 20% and increasing report accuracy by 12%., Ensured HIPAA and regulatory compliance.
Trainer
Conducted training for 55 agents and supervisors on Chartsquad processes., Developed interactive training materials and provided ongoing coaching., Supported bilingual (English/Spanish) training.
Paralegal (Asistente de Fiscal)
Drafted legal documents and supported prosecutors using digital tools., Managed and archived case folders, reducing search time by 30%., Developed Watson and Combicoran systems to optimize operations.
Sales Representative
Conducted B2B sales, achieving 100% of quotas and contributing to 10% revenue growth., Managed client data entry using CRM with bilingual support.