Moses Johnson

Senior Medical Accounts Receivable Specialist with 3+ years of experience in U.S.

Healthcare Revenue Cycle

Management (RCM), specializing in Physician Billing, insurance follow-up, denial management, appeals, reimbursement optimization, and account resolution. Proven success working in a Work From Home (WFH) environment for over two years while consistently achieving productivity and quality goals. Experienced in Epic EMR, Athena EMR, basic Allscripts, Availity, commercial insurance portals, Medicare, Medicaid, and payer websites.

Skilled in resolving denied and underpaid claims, reviewing aging reports, maintaining HIPAA compliance, and collaborating with cross-functional teams to maximize collections and improve revenue performance.

Senior Medical Accounts Receivable (AR) Specialist at Access Healthcare Services Pvt. Ltd. (2024-05 – Present)

• Manage U.S. Healthcare Physician Billing Accounts Receivable for high-volume provider accounts, ensuring timely reimbursement and reduced outstanding AR.
• Perform insurance follow-up with commercial and government payers including Medicare, Medicaid, UHC, Cigna, Aetna, BCBS and other payer portals to resolve unpaid, denied, rejected and underpaid claims.
• Investigate claim denials by reviewing EOBs, payer policies and account documentation to determine root causes and initiate appropriate resolutions.
• Submit corrected claims, appeals and reconsideration requests within payer timely filing guidelines, improving reimbursement success rates.
• Review aging reports daily, prioritize high-value accounts and implement effective collection strategies to minimize AR aging.
• Utilize Epic EMR, Athena EMR, basic Allscripts and Availity to verify insurance eligibility, claim status, payment details and patient account information.
• Maintain accurate documentation of account activities, follow-up actions and payer communications while ensuring HIPAA compliance and organizational quality standards.
• Collaborate with billing teams, quality analysts and internal stakeholders to resolve complex reimbursement issues and enhance revenue cycle efficiency.
• Perform SME-level responsibilities including assisting team members with claim resolution, workflow guidance, process clarifications and operational support.
• Consistently achieve productivity and quality KPIs by efficiently managing workload, reducing outstanding balances and maintaining high accuracy.
• Successfully work in a 100% Work From Home (WFH) environment for more than two years with reliable high-speed internet, dedicated home office setup and strong remote collaboration practices.
• Leverage Microsoft Excel and Google Workspace for reporting, documentation, account tracking, productivity monitoring and operational communication.

Medical Accounts Receivable (AR) Specialist at Omega Healthcare Management Services Pvt. Ltd. (2022-12 – 2023-06)

• Managed U.S. healthcare physician billing accounts by performing insurance follow-up, claim status verification and timely resolution of outstanding receivables.
• Worked with commercial insurance payers to resolve denied, rejected and underpaid claims, ensuring accurate reimbursement and reduced AR aging.
• Reviewed Explanation of Benefits (EOBs), payer guidelines and patient accounts to identify billing discrepancies and support first-pass claim resolution.
• Maintained accurate account documentation, complied with HIPAA regulations and consistently achieved assigned productivity and quality targets.

Bachelor of Science (B.Sc.) in Computer Science – University of Madras