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Skills

  • Denial Management
  • Medical Billing and Coding
  • Prior Authorization
  • Revenue Cycle Management
  • Accounts Receivable
  • Accounts Receivable (ar)
  • Billing
  • Claim Scrubbing
  • Eligibility Verification
  • Hipaa Compliance
  • Insurance Verification
  • Medical Documentation
  • Patient Demographics

Services

  • Medical Billing, RCM & Prior Autho

    $8/hr Starting at $40 Ongoing

    Dedicated Resource

    Highly accomplished Medical Billing, Denial Management, and Revenue Cycle Management (RCM) Specialist with 6 years of extensive experience maximizing revenue for U.S. healthcare providers across multi-specialty...

    Accounts ReceivableAccounts Receivable (ar)BillingClaim ScrubbingDenial Management

About

Premium Medical Billing, RCM & Advanced Denial Management Expert

A highly accomplished and result-driven Medical Billing, Denial Management, and Revenue Cycle Management (RCM) Specialist with 6 years of extensive hands-on experience maximizing financial performance for U.S. healthcare providers. My expertise spans across multi-specialty practices, with a deep focus on Internal Medicine, Cardiology, and Podiatry.

What truly sets me apart in the billing industry is my solid medical/nursing background. This clinical foundation equips me with the unique ability to accurately interpret complex clinical documentation, bridge the gap between medical charts and insurance requirements, and execute end-to-end RCM operations with flawless precision.

Core Strengths & RCM Expertise:
• End-to-End RCM & Precise Charge Entry
• Front-End Claim Auditing & Patient Demographics (Demo Creation)
• Real-Time Eligibility & Benefits Verification
• Proactive Prior Authorization Management (Medicare, Medicaid, Workers' Comp & Commercial)
• Clean Claim Generation & Submission (HCFA-1500)
• Advanced Denial Management, Rejections Analysis & Structured Appeals
• AR Optimization, Aging Matrix Analytics & Direct Phone/Portal Payer Campaigns

Technical Proficiency:
• EHR/PM Systems: eClinicalWorks (eCW Expert), AdvanceMD, Tebra, Athena, MODMED, EPIC, and WebPT.
• Clearinghouses: Availity, Optum, Waystar, Navinet, and Change Healthcare.

Proven Track Record of Impact:
• Maintained a Clean Claim Rate of over 90% on initial electronic submissions.
• Reduced Days in AR to well below the 40-day industry benchmark.
• Dropped net denial rates to under 5% through robust front-end verification.
• Boosted legacy AR resolution rates by 25% through aggressive aging analytics.

I am fully committed to maintaining strict HIPAA and CMS compliance across all workflows. Whether you need a high-performing billing asset to clear backlogs, an expert to drop your denial rates, or a virtual medical manager to optimize daily operational queues, I am here to deliver top-tier results that drive faster reimbursements and practice growth.

Let's connect and optimize your practice's financial health today!

Work Terms

Communication & Updates:
• Fully available during U.S. business hours (EST/CST) for seamless collaboration.
• Regular workflow reporting, including weekly updates on claim submissions, AR aging matrix, and denial resolutions.
• Available via Guru workspace messages, email, or scheduled Zoom/Teams calls.

Payment & Billing Terms:
• Flexible engagement options: Hourly rate or Fixed-budget milestones based on the project scope (e.g., clearing legacy AR backlogs or ongoing daily billing).
• Payments are securely processed through Guru SafePay escrow to ensure transparency and trust.

Compliance & Security:
• 100% HIPAA and CMS compliant operations. All patient data (PHI) is handled strictly via secure client EHR/PM portals and encrypted clearinghouses.