Medical Billing & RCM Specialist | AR Management
Camarines Norte, Daet, Philippines
I am a US Medical Biller with more than 4 years of hands-on experience in Accounts Receivable (AR) Management, Revenue Cycle Management (RCM), and Denials & Rejections resolution for US healthcare providers. I specialize in helping clinics and billing companies recover unpaid claims, reduce A/R days, and improve cash flow by ensuring accurate follow-ups, timely appeals, and payer-specific compliance. What I can help you with: ✔ AR follow-ups (Insurance & Patient AR) ✔ Denials & rejections analysis and resolution ✔ Timely filing & appeal submissions ✔ EOB analysis & payment posting review ✔ Claim status follow-ups via calls and portals ✔ RCM support from charge review to payment I am experienced in working with US insurance payers, understanding payer policies, and maintaining HIPAA compliance while meeting productivity and quality standards. I work best with: • Private practices • Medical billing companies • Clinics looking to outsource AR & denial work
Elevation Counsel, freelance
Jun 2024 to Jan 2026
Investigate and resolve all assigned insurance claim denials in a timely and efficient manner. Analyze denial trends to identify root causes and patterns by payer, provider, or service type. Develop, document, and implement standard operating procedures for resolving common denial reasons. Prepare and submit compelling appeals to insurance companies with all necessary documentation. Collaborate with the coding team and clinical staff to obtain corrected information or documentation for claim resubmission. Track and report on denial statuses, recovery rates, and the financial impact of denial trends. Maintain up-to-date knowledge of payer policies, billing regulations, and industry standards related to medical billing and denials. Perform other duties as assigned related to revenue cycle management.
California Dermatology, freelance
Jun 2022 to Jul 2024
Reviewed and requested prior authorizations from healthcare providers to facilitate timely patient treatments. Maintained accurate records of authorization requests and follow-up actions, enhancing the quality of patient records. Managed patient billing statements and posted payments via the patient portal. Posted claim payments and denials in the EHR system after reviewing explanation of payments/benefits (EOPs/EOBs). Demonstrated excellent communication and interpersonal skillswhen dealing with patients and insurance companies regarding insurance benefits and payment details.
SOHO MD, freelance
Sep 2019 to May 2022
Posted claim payments and denials in the EHR system after reviewing explanation of payments/benefits (EOPs/EOBs). Demonstrated excellent communication and interpersonal skills when dealing with patients and insurance companies regarding insurance benefits and payment details. Managed claims: entry, scrubbing, submission, and follow-up Called patients to update declined credit card information, responded to appointment inquiries, and input accurate data into the clinic’s scheduling or EMR system
Healthy Boss, freelance
Feb 2018 to Sep 2019
Contacted clinics, hospitals, and clients for patient account information. Managed inbound and outbound calls from facilities and patients. Reviewed and analyzed progress notes, clinical notes, prescriptions, and lab results Sent requests, referrals, and refills to healthcare facilities. Maintained organized communication and documentation for efficient patient care. Sent requests, referrals, and refills to healthcare facilities. Maintained organized communication and documentation for efficient patient care.