Medical Billing Specialist | Full Revenue Cycle Management | Accounts Receivable | Denial Management
Are unpaid claims, denials, and aging A/R slowing down your practice's cash flow?
I'm a Medical Billing and Accounts Receivable Specialist with 4+ years of U.S. medical billing experience and hands-on knowledge of the full revenue cycle, from patient and insurance information through claim submission, payment posting, denial management, A/R follow-up, appeals, and reimbursement resolution.
My strongest area is insurance A/R and difficult or aging claims. I investigate why claims remain unpaid, communicate directly with payers, identify billing or coding issues, submit corrected claims, request reconsiderations or manual reviews, file appeals, and follow through until the account reaches resolution.
FULL REVENUE CYCLE MANAGEMENT
• Patient and insurance information
• Eligibility and benefits verification
• Authorizations and referrals
• Charge entry and claim preparation
• CPT, HCPCS, and ICD-10-CM review
• CMS-1500 and UB-04 claims
• Claim submission and payer follow-up
• EOB/ERA and remittance review
• Payment posting and reconciliation
• Denial management and appeals
• Corrected claims and resubmissions
• Aged A/R and unpaid claim resolution
• Patient billing and balance inquiries
A/R AND DENIAL MANAGEMENT
I don't simply document a denial and move on. I research the claim history, verify payer requirements, identify the reason for non-payment, determine the appropriate next action, and follow up with the payer until the issue is resolved or the next step is clearly established.
EHR/EMR AND BILLING SYSTEMS
Tebra | NextGen | Epic | AdvancedMD | Elation | GoodLooking EMR
PAYER AND CLEARINGHOUSE PLATFORMS
Availity | Office Ally | Noridian | Payer-specific portals
PAYER EXPERIENCE
Medicare | Medicaid | Medicare Advantage | BCBS | UHC | Aetna | Humana | Anthem | TRICARE | Medi-Cal | Commercial Insurance
SPECIALTY EXPERIENCE
Family Medicine | Primary Care | Urgent Care | Podiatry | OB/GYN | Sleep Medicine | Mobile Wound Care | Medical Nutrition Therapy | Pulmonary/Critical Care | Emergency Medicine
TECHNICAL KNOWLEDGE
CPT | HCPCS | ICD-10-CM | CMS-1500 | UB-04 | EOB | ERA | Denial Codes | Appeals | Corrected Claims | Timely Filing | Medical Records
I'm comfortable working independently, managing multiple accounts and priorities, communicating directly with insurance companies, documenting follow-up accurately, and learning new EHRs, billing platforms, and payer workflows quickly.
My goal is simple: keep claims moving, reduce aging A/R, resolve denials, and help healthcare practices collect the reimbursement they are owed.
If you need a reliable Medical Biller who can handle full-cycle billing while also digging into difficult A/R and denials, let's connect.
Talk soon,
Gerald
