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Raul Guzman

Expertise In: OB Gyn

Name : Raul Guzman
Experience : 25
Specialty : OB Gyn
Location : StatenIsland,NY
Description :

Raul Guzman is seeking a coding position which allows utilization of Professional Coding and Organizational skill set to enhance the business objectives. Has a strong work ethic, is detail oriented, courteous, self- motivated and is a team player.


  • Accomplished professional with extensive experience in diverse areas of healthcare management
  • Proficiency in ICD9 CPT 4 coding and HCSPCS
  • Technical proficiency with Medical Billing systems such as Medical Manager, Advantx, ADS, IDX and Eagle.
  • Excellent leadership abilities concerning team initiatives
  • Comprehensive background in coding, accounts receivable, collections and credentialing
  • Skilled in report generation, encounter form development, data entry, and customer service


  • Supervisor staff of 6 community residence workers at a state operated facility
  • Case managing records of 9 mentally retarded adults
  • Coordinate all clients’ needs with respect to ADL and cognitive skills
  • Implement goals instituted by clinical staff
  • Prepare quarterly meetings with clinical
  • Monitor receivables for Neoplastics and Pediatric accounts to secure timely and appropriate payments
  • Research and resolve billing discrepancies, responds to inquire from patients and insurance carriers
  • Verified patient eligibility for benefits
  • Initiate collection activities to secure overdue payments
  • Posted charges and remittances
  • Filed claims with insurance carriers and generate appeals to carriers for payments
  • Managed all aspects of Physicians Billing for all Specialties
  • Preparation of Macro Procedures for chemotherapy billing of Hematology-Gyn/Oncology Practices
  • Performed Electronic Transmissions
  • Set performance standards and review work output of all subordinates
  • Educate staff on current trends and developments
  • Determined appropriate contractual adjustments and write offs
  • Monitor all insurance transactions to ensure providers comply with all regulations to facilitate maximum reimbursement
  • Responsible for maintaining and monitoring of Accounts Receivable, Charge Entry and Payment Posting operations  for Physicians of all specialties in the Dept of Medicine including, Allergy, PM&R, Endocrinology, Pulmonary and Infectious Disease.
  • Responsible for supervising 8 full time unionized employees inclusive of supervisory staff
  • Designed and implemented billing procedures to support the computerized operation
  • Recommend updates to IDX to insure compliance with third party billing requirements
  • Managed special projects to meet and exceed net collection targets
  • Designed customized reports to identify trends, isolated problems and increase revenue
  • Comply with third party audits, Medicare Appeals and Medicare Fair Hearing
  • Direct Account Receivable staff activities based upon analysis of financial reports
  • Credentialing physicians and other ancillary provider on all managed care carriers
  • Handled all Billing claims for 6 OB/Gyn Practice
  • Call insurance carriers and follow up on all accounts pending payment
  • Followed up with insurance companies to insure that all information needed was submitted to insure accurate payment
  • Handled patient inquiries regarding bill statements
  • Assisted in ICD 9 and CPT 4 coding
  • Insured all electronic transmission was accurately transmitted
  • Updated Physicians and staff on current events and updates
  • Assisted with credentialing process


  • Course in ICD-9 CPT-4 coding, Maximum Physicians Reimbursement
  • Member of the American Academy of Professional Coders