Ray Espinosa
@rayespinosa
I resolve complex hospital billing, denials, and reimbursements across Medicare, Medi-Cal, CCS, and managed care.
United StatesWhat I'm looking for
I'm currently handling Medicare Part B, Veterans Affairs, Tri-Care, Tri-West, Champva, and complex accounts at Dignity Health, submitting compliant UB-04 and CMS-1500 claims and resolving reimbursement issues.
At Children’s Hospital Los Angeles, I managed high-cost pediatric CCS and Medi-Cal claims, corrected specialty-service carve-out errors, and helped implement denial tracking strategies that reduced A/R by 20%.
Across Adventist Health Glendale and Huntington Memorial Hospital, I processed inpatient, outpatient, and professional claims, audited charges, reconciled underpayments, and aligned billing workflows with payer contracts and authorization requirements.
With more than 20 years in patient financial services, I bring hands-on experience in complex billing, bundle payments, case rates, denials, appeals, revenue integrity, and cross-department account resolution.
Experience
Work history, roles, and key accomplishments
Performs billing and collections for Medicare Part B, Veterans Affairs, Tri-Care, Tri-West, Champva, and complex accounts, ensuring CMS and payer compliance. Submits UB-04 and CMS-1500 claims, investigates denials, prepares appeals, and reconciles bundled payments and case rate contracts.
Biller / Collector Specialist – Government Accounts
Jan 2021 - Dec 2024 (3 years 11 months)
Managed CCS and Medi-Cal accounts, including high-cost pediatric and specialty claims. Processed UB-04 and CMS-1500 submissions, submitted appeals and CIFs, and implemented denial tracking strategies resulting in 20% A/R reduction.
Senior Biller / Collector – Medi-Cal & Managed Care
Jan 2019 - Dec 2021 (2 years 11 months)
Processed government and complex claims across inpatient, outpatient, and professional billing. Ensured proper TAR and authorization documentation, performed charge audits, and coordinated with Revenue Integrity to resolve denials.
Insurance Biller / Collector
Huntington Memorial Hospital
Jan 2007 - Dec 2019 (12 years 11 months)
Billed Medi-Cal and Managed Care inpatient and outpatient claims, ensuring TAR and authorization compliance. Processed refunds, adjustments, and charity write-offs, and managed payment posting and reconciliation.
Billing Office Manager (OB/GYN Specialty)
Private Medical Service, Inc.
Jan 2000 - Dec 2007 (7 years 11 months)
Supervised billing staff and trained employees on CPT/ICD coding, payer requirements, and claim follow-up. Managed credentialing, charge posting, claim submission, and appeals across multiple provider accounts.
Education
Degrees, certifications, and relevant coursework
DeVry University
Business Administration, Business Administration
Completed two years of coursework in Business Administration.
Montclair High School
High School Diploma, General Studies
Earned a high school diploma.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Salary expectations
Job categories
Skills
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