Healthcare BPO professional with hands-on experience using EHR platforms such as Epic Systems, athenahealth, and PointClickCare (PCC), supporting revenue cycle operations, medical billing, clinical prior authorization, and patient accounts. My background includes denial review, Explanation of Benefits (EOB) review, payment posting, refund processing, and account resolution across major payers including UHC, Anthem Blue Cross Blue Shield, Cigna, and Aetna.
I also provide administrative and automation support for service-based businesses, helping streamline day-to-day operations through calendar management, lead capture, appointment scheduling, customer inquiry handling, and social media content creation.
Beyond administrative support, I build workflow automation systems, landing pages, and simple websites designed to help service-based businesses capture and respond to leads, automate appointment booking, reduce missed opportunities, and improve follow-up. These systems can include 24/7 lead capture and response, lead qualification and routing, missed-call and after-hours response, appointment reminders, and customer inquiry management.
CORE SKILLS
• Healthcare Revenue Cycle Operations & Medical Billing: Medicare Part A, Medicare Part B (including Skilled Nursing Facility [SNF] therapy billing), and Medicare/Medicaid HMO billing workflows
• Payment Processing, Posting, Refunds & Write-Offs
• Insurance Claims Submission, Tracking, Follow-Up & Denial Review: Appeals and reconsideration submissions for denied or underpaid claims
• Insurance Benefits & Eligibility Verification
• Prior Authorization Submission & Follow-Up: Insurance and Workers' Compensation
• Aged AR Analysis: Reviewing and prioritizing outstanding claims across 30/60/90/120+ day aging buckets to help accelerate reimbursement
• Direct Payer Follow-Up via calls, payer portals, and written correspondence to move outstanding claims toward resolution and payment
• Medical Billing Software & Tools: Billboard, Waystar, Inovalon Clearinghouse
• EHR & Case Management Systems: Epic EHR, athenahealth EHR, PointClickCare (PCC), Salesforce, etc.
• Insurance Payer Portals, EOB & ERA Review: Availity, UHC, Anthem Blue Cross Blue Shield, Cigna, Aetna, etc.
• Administrative Support & Workflow Coordination
• Calendar & Appointment Management
• Social Media Management & Content Creation
• Microsoft 365: Excel, Word, PowerPoint, Outlook, Teams, OneDrive
• Google Workspace: Gmail for Business, Google Drive, Google Sheets, Google Meet, Google Calendar
• HIPAA Compliance
WORKFLOW AUTOMATION, LANDING PAGES & SIMPLE WEBSITES
I help service-based businesses streamline lead handling and appointment processes through practical workflow automation, including:
• Automated Appointment Booking
• 24/7 Lead Capture & Instant Response Automation
• Lead Follow-Up Automation
• Lead Qualification & Routing Automation
• Missed-Call & After-Hours Response Automation
• Appointment Reminder & Follow-Up Automation
• Customer Inquiry Management Automation
• Landing Pages for Lead Capture
• Simple Websites
I’m committed to accuracy, reliable communication, and HIPAA-compliant handling of healthcare-related information. I adapt quickly to new tools, platforms, and workflows and can support both healthcare organizations and other service-based businesses.
Feel free to reach out if you need help with medical billing, revenue cycle operations, administrative support, or building workflow automation systems.
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