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6 anos de experiência

Competências

Accounts Receivable Follow‑Up & Aging Revenue Cycle Management (RCM) Denial Management & Appeals Insurance Payer Follow‑Up Underpayment & Payment Variance Analysis EOB/ERA Analysis & Payment Posting Corrected Claims & Reprocessing COB / Eligibility & Benefits Verification Medicare & Medicaid Billing UB‑04 / CMS‑1500 Billing Workers’ Compensation Billing Motor Vehicle Accident (MVA) Claims Out‑of‑Network Billing Prior Authorizations & Insurance Verification HIPAA Compliance

Experiência

Senior Medical Billing Executive – Accounts Receivable

Right Medical Billing – U.S.-Based Clients

2025-05 -

Manage end‑to‑end insurance AR follow‑up for U.S. healthcare providers, focusing on aged, high‑value, denied and underpaid claims. Investigate claim status, denial reasons and payment discrepancies using payer portals, EOB/ERA data and direct communication with payers. Resolve denied and underpaid claims through corrected claims, appeals, reprocessing requests and escalations. Analyse EOB and denial trends to identify root causes, reduce outstanding AR and improve reimbursement outcomes. Coordinate with internal billing teams and payer representatives to ensure timely reimbursement while meeting productivity and revenue recovery targets.

Backup Team Lead – Medical Billing

Preferred Medical Billing

2023-03 - 2025-04

Supported full‑cycle RCM and AR workflows for multiple U.S. medical practices, reviewing claims for accuracy to minimize billing errors and avoidable denials. Managed denial resolution, AR follow‑up, payment variance analysis and appeals processing. Assisted team members with workflow management, escalations and day‑to‑day operational support. Monitored account performance and ensured consistent follow‑up on outstanding insurance balances, contributing to reduced AR aging and improved cash flow.

Account Manager – Operations

CareCloud (MTBC)

2020-04 - 2023-01

Managed provider accounts and coordinated billing operations to ensure accurate and timely reimbursement. Collaborated with coding and billing teams to guarantee correct claim submission and resolve account issues. Performed insurance follow‑ups, payment reconciliation and denial resolution across assigned accounts. Reduced AR aging through proactive payer communication, claim follow‑up and timely issue escalation. Served as primary client liaison, supporting operational coordination and enhancing provider satisfaction.

Idiomas

English

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