Senior AR Medical Billing Specialist | US Healthcare RCM
Cavite
Hi! I’m a Medical Billing and AR Specialist with 5 years of experience in US Healthcare RCM. My expertise includes charge entry, insurance billing, claims follow-up, denial management and insurance verification. I have hands-on experience with Epic, Cerner, Trubridge, Oracle Works, Open Practice Solutions and Medent. I’m detail-oriented, proactive, and skilled at resolving billing issues, managing claims efficiently, and maintaining accuracy. My goal is to help healthcare providers streamline their billing processes, reduce denials, and improve collections through reliable, high-quality work.
Amazon Financial Operations, full_time
Apr 2024 to Oct 2026
I am responsible for managing and resolving claim denials from US insurance companies on behalf of healthcare providers and physicians. I regularly review and analyze denied claims to identify the reasons for denial and develop strategies to address them. I handle communication with insurance payers through provider portals, phone calls, emails, and even paper mail to follow up on these claims and ensure payments are received in a timely manner. When needed, I also submit reconsideration requests and appeals, making sure all claims are supported by the proper documentation such as medical records or additional information. I track the progress of claims from submission to resolution and keep providers and management updated on their status. Additionally, I collaborate closely with internal teams like billing and coding to resolve any issues related to coding errors or missing documentation that may impact claims. My role also involves maintaining detailed records of follow-up activities, payer responses, and payment outcomes within the accounts receivable system. I monitor and ensure we meet key performance indicators such as denial resolution times, accounts receivable aging, and cash collection targets. Staying updated on payer policies, procedures, and any changes in industry regulations is essential to my role in ensuring effective claims resolution and reimbursement.