RESULTS-DRIVEN MEDICAL VIRTUAL ASSISTANT (MedVA) with 5+ years of hands-on experience optimizing healthcare operations and managing front-to-back Revenue Cycle Management (RCM) for large-scale US hospital networks.
Proven track record of managing 80–100 inbound and outbound patient/provider calls daily while consistently maintaining elite 95–100% KPI, QA, and CSAT scores. Backed by an undergraduate clinical background in BS Nursing and 11 formal healthcare certifications from AAPC, MedCerts, and Rice University. Thoroughly trained in strict HIPAA privacy standards and data security protocols.
CORE EXPERTISE & SEARCHABLE TECHNICAL KEYWORDS:
• EHR/EMR Architecture: Expert-level system navigation within Epic Systems (including Epic Prelude for demographic registration and patient intake, and Epic Cadence for complex multi-department scheduling and calendar management). Highly adaptable to OpenEMR, DrChrono, and Practice Fusion.
• Insurance Verification & Eligibility: Executing real-time eligibility checks for 80+ patient accounts daily utilizing Availity Essentials, Waystar, and primary commercial/government payer portals (UHC Link, BCBS, Cigna, Aetna) to extract comprehensive benefit breakdowns (co-pays, deductibles, co-insurance).
• Prior Authorizations (ePA): Reviewing electronic health records to extract clinical documentation, submitting electronic prior authorization requests via Cover-----------ds and Availity AuthAI, and routing administrative appeals to prevent patient care delays.
• Denial Management & Claims Processing: Investigating root causes for medical claim denials, pulling supporting clinical paperwork, and coordinating administrative appeals to help billing departments minimize revenue leakage.
• Virtual Scribing & Medical Knowledge: Advanced understanding of medical terminology, anatomy, and SOAP note structures (99% score in Rice University’s Medical Series). Familiar with AI medical scribes (Heidi Health, Freed AI, DeepScribe) for streamlined documentation.
TECHNICAL TECH STACK SUMMARY:
• EHR/EMR: Epic Systems (Hyperspace, Prelude, Cadence), OpenEMR, DrChrono
• RCM Platforms: Availity Essentials, Availity AuthAI, Waystar, Cover-----------ds
• Payer Portals: UnitedHealthcare, Blue Cross Blue Shield, Cigna, Aetna
• Telephony/CRM: Genesys Cloud CX, NICE InContact, RingCentral, Zoom for Healthcare
• Compliance: 100% HIPAA Compliant (Verification ID: HIPAA-----------)
REMOTE WORK READINESS:
Operates out of a dedicated, distraction-free home office fully equipped with a dual-monitor setup, noise-canceling peripherals, fiber internet (with secondary backup), and an active UPS battery backup. Fully available to work full-time hours matching US (EST, CST, MST, PST) clinic operating schedules.
