Open to opportunities

Karim Gomez

@karimgomez

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Dedicated Billing and Collection Specialist with strong analytical skills.

United States

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What I'm looking for

I am looking for a role that values analytical skills and offers growth opportunities in healthcare finance.

I am a dedicated Billing and Collection Specialist with over six years of progressive experience in the healthcare sector. My career has been marked by a commitment to driving financial efficiency and compliance, particularly in optimizing revenue cycles and navigating complex billing regulations. I have a proven track record of reducing discrepancies and enhancing operational processes, which has significantly contributed to the financial health of the organizations I have worked with.

At VNS Health, I spearheaded the design and implementation of an accounts receivable aging spreadsheet that reduced write-offs from 3% to 1%. My role involved collaborating on an implementation team to ensure Medicaid Electronic Visit Verification compliance, generating and analyzing financial reports, and conducting thorough audits of patient invoice documentation. My analytical skills and attention to detail have enabled me to identify potential payer reimbursements and optimize aging bucket analysis effectively.

With a Master of Science in Healthcare Administration anticipated in Summer 2025, I am eager to leverage my strong analytical and leadership capabilities to contribute to a thriving healthcare financial landscape. I am passionate about fostering team proficiency and adherence to standards, as demonstrated by my experience in training and mentoring new employees in operational procedures and regulatory compliance.

Experience

Work history, roles, and key accomplishments

Billing Coordinator

VNS Health

Jan 2019 - Mar 2025 (6 years 2 months)

Spearheaded the design and implementation of an AR aging spreadsheet, reducing write-offs from 3% to 1% by identifying potential payer reimbursements and optimizing aging bucket analysis. Collaborated on an implementation team to ensure Medicaid Electronic Visit Verification (EVV) compliance in billing processes, guaranteeing accurate claim processing. Generated and analyzed weekly AR finance repo

Revenue Cycle Management Electronic Claims Processing Financial Reporting Compliance Data Analysis Process Improvement Auditing

Hospice Intake Coordinator

VNS Health

Mar 2016 - Jan 2019 (2 years 10 months)

Facilitated patient admissions by collaborating effectively with patients, families, physicians, and interdisciplinary medical teams. Audited electronic health records (EHRs) to ensure data accuracy and compliance with Medicare/Medicaid standards, preventing payment interruptions. Streamlined pre-authorization processes, including referral entry, insurance verification, and scheduling, ensuring se

Electronic Health Records Medicare Medicaid Compliance Insurance Verification Scheduling Training Mentoring Data Management

Enrollment Specialist

CenterLight Health Systems

Apr 2015 - Oct 2015 (6 months)

Resolved complex member inquiries regarding PACE program services, claims, grievances, appeals, and prior authorization statuses. Managed the secure provision of clinical and demographic documents to professional staff and providers, ensuring strict HIPAA compliance. Accurately performed data entry for standing orders, medical appointments, and site visits.

Member Inquiry Resolution HIPAA Data Entry Claims Management Grievances Appeals Document Management

Education

Degrees, certifications, and relevant coursework

University of Maryland Global Campus

Master of Science, Healthcare Administration

Anticipated completion in Summer 2025. Focused on advanced topics in healthcare administration.

College of Staten Island

Bachelor of Science, Accounting

Completed a comprehensive curriculum in accounting principles and practices. Gained expertise in financial reporting and analysis.

Johns Hopkins University - Whiting School of Engineering

Certificate, Computer Programming/Software Engineering/Web Development

Completed a program in computer programming, software engineering, and web development. Acquired foundational skills in various programming languages and development methodologies.