Professional Summary
Medical Billing & RCM Specialist with 5+ years managing end-to-end revenue cycle operations for hospitals, group practices, and individual providers — with specialized expertise in No Surprises Act (NSA) disputes, IDR, and Arbitration for out-of-network billing.
Recent impact:
• Achieved a 90%+ IDR and Arbitration win ratio across all payers, securing maximum reimbursement for out-of-network claims
• Reduced AR days to 30 through proactive claims follow-up and root-cause denial resolution
• Maintained a 98% clean claim submission rate via rigorous eligibility verification and prior authorization checks
Core expertise: AR & Denial Management | Payment Posting & ERA/EOB Reconciliation | HIPAA/Medicare/Medicaid Compliance | ICD-10, CPT, HCPCS | NSA & IDR Arbitration
Open to connecting with healthcare providers, RCM companies, and recruiters looking for a results-driven billing specialist who protects revenue and reduces payer friction.
Recent impact:
• Achieved a 90%+ IDR and Arbitration win ratio across all payers, securing maximum reimbursement for out-of-network claims
• Reduced AR days to 30 through proactive claims follow-up and root-cause denial resolution
• Maintained a 98% clean claim submission rate via rigorous eligibility verification and prior authorization checks
Core expertise: AR & Denial Management | Payment Posting & ERA/EOB Reconciliation | HIPAA/Medicare/Medicaid Compliance | ICD-10, CPT, HCPCS | NSA & IDR Arbitration
Open to connecting with healthcare providers, RCM companies, and recruiters looking for a results-driven billing specialist who protects revenue and reduces payer friction.
Job Responsibilities
Current Responsibilities
IDR Specialist || END-To-END RCM Specialist
Arthur Lawrence · Full-time
Feb 2025 - Present · 1 yr 9 mos
Islāmābād, Pakistan · On-site
Lead end-to-end revenue cycle operations for hospitals, group practices, and individual providers, with a specialized focus on out-of-network dispute resolution under the No Surprises Act.
• Achieved a 90%+ win ratio on Open Negotiation and Federal IDR cases across all payers, recovering underpaid and denied out-of-network claims
• Reduced AR days to 30 through proactive insurance follow-up, underpayment resolution, and denial root-cause analysis
• Maintained a 98% clean claims rate across commercial, Medicare, and Medicaid submissions, minimizing rework and payer friction
• Manage hospital billing across inpatient, outpatient, and emergency services, ensuring compliance with complex, multi-payer billing rules
• Ensure full HIPAA and federal/state regulatory compliance across all billing and dispute-resolution activity
Previous Responsibilities
Senior Medical Billing Specialist || End To End RCM Specialist || Denial Management || AR Follow Up
Weblify Private Limited · Full-time
Jun 2021 - Feb 2025 · 3 yrs 9 mos
Rawalpindi, Punjab, Pakistan · On-site
Medical Billing & Revenue Cycle Expertise:
• Patient Eligibility & Benefits Verification – Processed insurance verification to ensure coverage accuracy.
• Clean Claims Submission – Successfully managed error-free billing to minimize rejections and delays.
• Accounts Receivable (A/R) Follow-Up – Tracked unpaid claims, resolved discrepancies, and reduced AR days.
• Denial & Rejection Management – Expert in analyzing payer denials, correcting errors, and resubmitting claims for maximum reimbursement.
• Payment Posting & Reconciliation – Accurately posted payments, adjustments, and denials to maintain financial records.
• Billing Software Proficiency – Skilled in multiple RCM platforms for efficient claims processing.