Benjamin R. Castillo Jr II

Coding Educator and Auditor

Enara Health

Jan 2024 - Dec 2025 (2 years)

Provided coding education to coders, billers, and providers regarding coding and payer-specific guidelines. Conducted coding audits and calibration sessions for medical records and claims. Researched insurance policies and developed telehealth coding SOPs. Performed coding, billing, denial review, and corrected claim resubmissions.

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Team Lead

Shearwater Health Advisors

Jan 2021 - Dec 2024 (4 years)

Led and supervised a team of outpatient and inpatient coders supporting ED, clinic, same-day surgery, and observation services. Ensured accurate DRG assignment and compliance with official coding guidelines. Conducted routine coding audits, productivity reviews, and quality assessments to identify improvement opportunities. Delivered continuous coaching, training, and education to improve team performance and accuracy. Collaborated with management and cross-functional teams to implement corrective action plans. Managed inventory tracking and client escalation resolution.

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Assistant Manager

Optum Global Solutions Inc.

Jan 2018 - Dec 2021 (4 years)

Managed teams of medical coders, billing associates, and accounts receivable specialists. Oversaw end-to-end claim submission, billing, and AR workflows. Monitored daily operations, workload allocation, and SLA adherence. Addressed escalations from onshore and offshore stakeholders. Performed billing audits and provided actionable feedback to staff. Partnered with leadership to execute operational and performance improvement initiatives.

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Project Lead

Xilium Professional Services Inc

Jan 2016 - Dec 2018 (3 years)

Conducted in-house training programs for new hires covering front-end, middle, and back-end RCM processes. Served as Project Lead for data entry and EMR management initiatives. Transitioned new hires from training to production and supported client onboarding and transitions. Developed training matrices and standardized workflows to ensure smooth implementation. Acted as subject matter expert for eligibility verification and prior authorization. Reviewed provider documentation to validate diagnoses, procedures, comorbidities, and complications prior to claim submission. Escalated coding discrepancies to billers, clients, and insurance providers.

Benjamin R. Castillo Jr II

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