Professional Summary
Senior Medical Billing Executive with 7+ years of experience in U.S. healthcare medical billing and Revenue Cycle Management (RCM). Experienced in A/R follow-up, denial management, claims submission and resolution, appeals, payment posting, insurance eligibility verification, and recovery of outstanding and underpaid claims. Skilled in working with Medicare, Medicaid, and commercial insurance payers, as well as platforms including eClinicalWorks (eCW), AdvancedMD, NextGen, ModMed, SequelMed EPM, TriZetto, and Availity. Seeking a remote opportunity where I can use my expertise to improve claim resolution, reduce aged A/R, and support revenue recovery.
Job Responsibilities
Current Responsibilities
- Manage end-to-end medical billing and accounts receivable (A/R) activities for U.S. healthcare providers.
- Submit electronic claims to Medicare, Medicaid, and commercial insurance payers.
- Perform A/R follow-up on unpaid, underpaid, denied, and rejected claims.
- Investigate claim denials and rejections, resolve billing issues, and submit corrected claims and appeals as needed.
- Review payment discrepancies and support recovery of outstanding and underpaid claims.
- Handle charge entry, payment posting, claim status checks, and A/R aging follow-up.
- Verify payer requirements and ensure compliance with billing guidelines.
- Coordinate with providers and coding teams to resolve claim-related issues.
- Support process improvement and mentor team members to improve billing workflow and claim resolution.
Previous Responsibilities
- Processed and followed up on medical claims for U.S. healthcare providers.
- Verified patient insurance eligibility and benefits.
- Investigated denied, rejected, unpaid, and underpaid claims and worked toward resolution.
- Prepared and submitted claim appeals and corrected claims when required.
- Posted insurance payments and reconciled payment records.
- Followed up with insurance payers regarding claim status and outstanding balances.
- Prepared patient invoices and statements and assisted with patient billing inquiries.
- Supported accurate billing operations and timely accounts receivable resolution.