Medical Biller / Accounts Receivable (AR) Specialist

Oct 2024 - Apr 2026

Spearheaded full-cycle medical billing and advanced A/R follow-ups, reducing days in accounts receivable by 22% within 6 months. Audited complex claim rejections and managed appeals, recovering 15% of denied revenue. Evaluated patient eligibility and pre-authorizations to prevent denials. Collaborated with coding and clinical teams to deploy billing workflows.

Medical Biller / Account Verification Specialist

Jun 2023 - Oct 2024

Directed front-end verification workflows for pain management treatments, reducing billing errors by 25%. Resolved insurance discrepancies before appointments to ensure clean claim submissions. Secured prior authorizations for high-dollar procedures, avoiding out-of-network penalties. Built and managed authorization tracking system to prevent care disruptions and billing gaps.

Medical Biller / Accounts Receivable (AR) Specialist

Jun 2021 - Jun 2023

Managed multi-specialty accounts receivable portfolios, exceeding monthly collection targets by 8% through aging audits. Prioritized high-dollar aging accounts to optimize cash flow. Reconciled EOBs/ERAs, posted payments accurately, and compiled appeals to overturn underpaid claims.

Denial Claim Specialist

Feb 2012 - Jun 2021

Served as internal expert for Medicare, Medicaid, and commercial plan denials. Audited, corrected, and resubmitted claims within payer timelines. Maintained follow-ups on high-volume claims to ensure rapid processing and adjudication.

Member / Provider Insurance Specialist

Jan 2009 - Jan 2012

Handled escalated phone inquiries interpreting Medicare replacement plan guidelines, eligibility, and claims processing for members and providers. Educated stakeholders on appeals workflows, resolving complex billing disputes on first contact.