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Gloria Elena Aguilar Ruiz

@gloriaelenaaguilarru

Medical billing and insurance specialist who handles claims, prior authorizations, and payer follow-up for Medicare, Medicaid, and commercial plans.

Nicaragua

Message

I verify eligibility, benefits, copays, deductibles, and authorization requirements for Medicare, Medicaid, and commercial plans. I submit and track prior authorizations, follow up on denials and coverage issues, and update patient and insurance records.

At CONAC International, I reviewed and submitted CMS-1500 and UB-04 claims and handled follow-up, denials, corrections, appeals, and collections. I also bring bilingual customer service experience and have taught English to primary and secondary students, including at Colegio María Mazzarello.

Experience

Work history, roles, and key accomplishments

Medical Billing and Insurance Follow-Up

CONAC International

Jan 2025 - Dec 2026 (1 year 11 months)

Reviewed and submitted CMS-1500 and UB-04 claims and verified patient registration and insurance information. Tracked unpaid claims and payments through payer portals and clearinghouses, handling denials, corrections, appeals, collections, and escalations.

Medical Billing CMS 1500 UB 04 Claims Processing Payer Portals Denial Management Collections Appeals

Hotel Reservations

InterContinental Metrocentro

Jan 2014 - Dec 2014 (11 months)

Managed bookings, availability inquiries, and reservation updates.

Reservations Booking Management Customer Service

Events and Banquets

Hilton Princess

Jan 2012 - Dec 2012 (11 months)

Coordinated guest requests and special arrangements with the events team.

Event Coordination Banquet Service Guest Relations

Front Desk and Guest Services

Holiday Inn Select

Jan 2011 - Dec 2011 (11 months)

Assisted with check-in, check-out, and guest inquiries.

Front Desk Operations Guest Service Check in Check out

Insurance Verification Specialist

Remote

Verify eligibility, benefits, copays, deductibles, and authorization requirements for Medicare, Medicaid, and commercial plans. Submit and track prior authorizations, follow up on denials and coverage issues, and update patient accounts and insurance records.

Insurance Verification Medicare Medicaid Prior Authorizations Denial Management Payer Portals Billing Customer Service

English Instructor

Colegio María Mazzarello

Taught English to primary and secondary school students.

English Teaching Curriculum Delivery Classroom Management

English Tutor

Self Employed

Provided supplemental English lessons to reinforce classroom learning.

English tutoring Individualized Instruction Language Reinforcement

English Instructor

Academy in Masaya

Taught English at an academy in Masaya, Nicaragua.

English Teaching Lesson Planning Student Assessment

Customer Service, Sales, Retention and Collections

Various Companies

Provided bilingual customer support by chat, email, and phone, resolving account issues, service inquiries, and customer complaints. Supported sales, customer retention, collections, and account follow-up while meeting performance goals.

Bilingual Customer Support Complaint Resolution Sales Retention Collections Account Management