Hector Gomez Jr Email & Phone Number

San Diego, California, United States

• Daily Workload Management: Assist in managing daily workload to ensure the timely and accurate completion of critical Payor Relations/EDI functions.
• Support in SQL Analysis: Utilize SQL under the guidance of more experienced team members to support basic monitoring and analysis tasks.
• Payor Configuration Assistance: Help ensure the correct and timely completion of payor configurations, including payor ID, submission service, and other fields, by conducting reviews and providing support.Payor.
• Documentation Support: Contribute to documenting business processes to enhance clarity and ensure consistency within the team.
• ERA Data Analysis Support: Assist in analyzing ERA data to identify potential opportunities for provider enrollments and reduce the need for manual posting.
• Adherence to Regulatory Guidelines: Strictly adhere to HIPAA and other applicable regulations to maintain the privacy and security of healthcare information.

San Diego, California, United States

• Provide support to EDI Enrollment Analyst
• Excel spreadsheet/tracking maintenance.
• Review XIFIN customer’s payers list for use in RPM system.
• Assist providers with EDI related issues and follow up on provider inquiries.
• Review and maintain training tools.
• Manage payer cases including processing and tracking payer add/load requests.

• Meet or exceed all call center metrics including but not limited to handle rate, talk time, work time, hold timeand not ready time.
• Receive calls from patients and collect payment for medical procedures on their account.
• Review claims for errors and correct demographic information, insurance information, explains insuranceadjudication and Explanation of Benefits.
• Protects patients’ rights by maintaining confidentiality of personal and financial information in order to comply with HIPAA and Practice requirements.

San Diego, California

Lemon Grove, California