Medical Billing RCM Specialist | AR, Denials Claims Expert
Albay
I am a Medical Billing and Revenue Cycle Management (RCM) Specialist with 3 years of experience working with healthcare providers across the United States. My expertise includes insurance verification, charge entry, claims submission, payment posting, denial management, AR follow-up, and appeals processing. I have experience working with Medicare, Medicaid, Commercial, and Managed Care payers using platforms such as Tebra, Availity, Change Healthcare, and Trizetto. My goal is to help healthcare practices maximize revenue, reduce denials, and improve cash flow through accurate and efficient billing processes.
eCuremd, full_time
Mar 2023 to Present
As a Medical Billing Specialist at eCureMD, I manage end-to-end Revenue Cycle Management (RCM) processes for healthcare providers across the United States. My responsibilities include insurance eligibility verification, charge entry, claim submission, payment posting, denial management, accounts receivable (AR) follow-up, and appeals processing. I work closely with insurance companies, providers, and patients to ensure accurate claim processing and timely reimbursement. Key Responsibilities: Submit and track medical claims to Medicare, Medicaid, and commercial insurance payers. Perform insurance eligibility and benefits verification. Process charge entry and payment posting with high accuracy. Investigate and resolve denied, rejected, and underpaid claims. Conduct AR follow-up to maximize collections and reduce aging balances. Prepare and submit claim appeals and corrected claims. Analyze EOBs and ERAs to identify payment discrepancies. Work with clearinghouses including Tebra, Availity, Change Healthcare, and TriZetto. Ensure compliance with payer guidelines, ICD-10, CPT, and HCPCS coding standards. Generate billing reports and monitor key performance indicators to improve revenue cycle efficiency. Achievements: Successfully managed billing operations for multiple healthcare practices. Helped increase claim acceptance rates through accurate claim review and denial prevention. Improved revenue recovery through effective AR follow-up and appeals management. Supported healthcare providers in optimizing cash flow and reducing reimbursement delays.