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 practices, including Internal Medicine, Cardiology, and Podiatry.
What sets me apart is my strong medical/nursing background, which allows me to deeply interpret complex clinical documentation, execute end-to-end RCM operations, and drive aggressive Accounts Receivable (AR) recovery strategies.
My Specialized Expertise Includes:
• End-to-End RCM & Accurate Charge Entry
• Front-End Claim Auditing & Precise Patient Demographics Creation (Demo Creation)
• Real-Time Eligibility & Benefits Verification
• Seamless Prior Authorization Management (Medicare, Medicaid, Workers' Comp & Commercial)
• Clean Claim Generation & Submission (HCFA-1500)
• Advanced Denial Management, Resolution & Structured Appeals
• AR Recovery, Aging Matrix Analytics & Focused Phone/Portal Payer Campaigns
Expert Command Over EHR/PM Platforms & Clearinghouses:
• Systems: eClinicalWorks (eCW Expert), AdvanceMD, Tebra, Athena, MODMED, EPIC, and WebPT.
• Clearinghouses: Availity, Optum, Waystar, Navinet, and Change Healthcare.
Proven RCM Metrics & Achievements:
• Maintained a Clean Claim Rate of over 90% on initial electronic submissions.
• Successfully reduced Days in AR to well below the 40-day industry benchmark.
• Dropped net denial rates to under 5% via robust front-end verification.
• Boosted legacy AR recovery rates by 25% through aggressive aging matrix analytics.
I am fully committed to maintaining strict HIPAA and CMS compliance while streamlining your clinic's workflows to guarantee faster reimbursements and maximized practice collections. Let's connect to optimize your revenue cycle today.