Lance Q.
Medical Claims Review Specialist | Medical Billing Review Specialist
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About
Detail-oriented Medical Billing Support Specialist with experience supporting U.S. healthcare billing operations through medical bill review, patient information validation, documentation review, quality assurance, and billing workflow support. Skilled in identifying discrepancies, reviewing medical records, maintaining accurate billing documentation, and escalating issues for resolution. Recognized for strong attention to detail, accuracy, productivity, and ability to follow strict guidelines and established procedures.
Experienced in high-volume healthcare administrative environments and committed to delivering accurate, compliant, and organized billing support. Fast learner with a strong willingness to expand knowledge of medical billing systems, claim processing workflows, and healthcare operations.
Experience
Medical Billing Support Specialist / Medical Billing Review Specialist at Shearwater Health Advisors (2023-06 – 2026-03)
- Review medical bills and patient records to ensure accuracy, completeness, and compliance with internal guidelines.
- Verify patient demographic information and identify discrepancies requiring correction or escalation.
- Review supporting medical documentation, provider notes, EOBs, and appeals-related records.
- Document findings and create detailed notes for billing corrections, clarification requests, or further review.
- Identify missing information, documentation inconsistencies, and billing-related issues affecting workflow accuracy.
- Escalate complex billing concerns, appeals, and documentation issues to designated team leaders for resolution.
- Maintain accurate records and case documentation within internal billing systems.
- Support quality assurance initiatives by identifying errors before downstream processing.
- Collaborate with internal teams to ensure billing records remain complete, organized, and up to date.
- Consistently meet productivity and quality standards while handling high-volume workloads.
Education
Bachelor of Science in Nursing – Escuela Nuestra Senora De La Sallete School (2011-03)
