I am a results-driven professional with over six years of comprehensive experience in U.S. healthcare operations, billing, patient services, technical support, and business development. I specialize in analyzing complex challenges and applying best practices to improve efficiency, reduce costs, and boost productivity while maintaining high client and patient satisfaction. Adaptable and quick to learn, I thrive in dynamic, fast-paced environments.
My healthcare experience covers end-to-end RCM, including charge auditing, insurance verification, prior authorizations, claims resolution, denial management, patient coordination, and medical billing. As a Charge Audit Specialist, I ensured accurate billing by auditing clinical documentation and validating CPT, HCPCS, ICD-10-CM codes, and billing modifiers according to Medicare, Medicaid, and commercial payer guidelines. I supported departments such as Emergency, Radiology, Surgery, and Cardiology, using systems like Epic 3M and Meditech. Key achievements include recovering significant revenue by correcting under- and overcharges, reducing claim denials, and streamlining audit workflows.
At BetterNight, I supported sleep therapy services by educating patients, scheduling appointments, managing medical billing, and ensuring HIPAA compliance through Brightree CRM and EHR tools. I collaborated closely with clinical and administrative teams to enhance therapy adherence and patient satisfaction.
As an Insurance Verification Specialist and Case Manager at Rula, Path CCM, and SUD Specialty Group, I managed insurance eligibility and benefits verification for behavioral health and primary care, securing prior authorizations and guiding patients through insurance complexities. At Breg, I handled DME insurance verification, claims processing, and denial resolution to ensure timely reimbursement and excellent patient support.
I am proficient with RCM and healthcare systems such as Epic, AdvancedMD, 3M, DME Scripts, Allscripts, GoScripts, Brightree, and payer portals including Availity and TevixMD. My knowledge spans commercial insurance, Medicare, Medicaid, workers’ compensation, and auto insurance billing.
Beyond healthcare, I offer strong skills in customer relations, technical support, process optimization, and business development. I am experienced with Salesforce, HubSpot, and multiple EHR/EMR systems, and excel in both remote and hybrid work settings.
If you’re seeking a dedicated professional to optimize healthcare operations, improve customer experiences, and drive business growth, let’s connect!