Rizwan Sheeraz

Results-driven RCM Lead & Senior Revenue Cycle Specialist with over 10 years of progressive experience in U.S. healthcare medical billing, accounts receivable, and end-to-end revenue cycle operations. Proven expertise in leading billing teams, optimizing workflows, reducing claim denials, and accelerating cash flow. Strong command of payer guidelines, compliance standards, and performance metrics with a hands-on leadership approach.

Adept at cross-functional coordination, mentoring teams, and driving operational excellence to achieve organizational revenue goals.

RCM Specialist - FHP Pvt Ltd

(2021-10)

Lead and oversee day-to-end RCM and medical billing operations for assigned providers with proven leadership and management experience in Medical Billing.

• Lead and oversee day-to-day RCM and medical billing operations for assigned providers
• Proven leader with 2 years of management experience in Medical Billing, successfully overseeing team operations, performance management, quality assurance, and client deliverables while maintaining operational excellence
• Supervise, guide, and mentor billing and AR team members to meet productivity and quality targets
• Review team work for accuracy in charge entry, claim submission, and payment posting
• Conduct AR aging analysis and prioritize high-dollar and time-sensitive accounts
• Perform root-cause analysis on denials and implement corrective action plans
• Coordinate with providers and internal departments to resolve documentation and compliance issues
• Track KPIs including denial rate, days in AR, and collection performance
• Support process improvements to enhance cash flow and reduce rework
• Manage end-to-end medical billing and accounts receivable operations
• Generate, review, and submit accurate claims to Medicare, Medicaid, and commercial payers
• Follow up on unpaid and underpaid claims to ensure timely reimbursement
• Research and resolve payment discrepancies and denial issues
• Review AR aging reports and maintain compliance with payer guidelines
• Perform account reconciliations and maintain accurate billing records
• Coordinate with internal teams to ensure correct billing information
• Mentor junior billing staff and support team productivity

Senior Medical Billing & AR Specialist - APFSOFT Pvt Ltd

(2019-02 - 2021-09)

• Enter and verify patient demographics and insurance information
• Perform insurance eligibility and benefits verification
• Review operative reports and enter charges accurately per payer contracts
• Submit clean electronic and paper claims with required documentation
• Post insurance payments and submit secondary claims when applicable
• Reduce denials through accurate documentation review and follow-up
• Maintain patient financial records and update billing information
• Streamline billing workflows to improve efficiency and accuracy

Medical Billing Executive - SEQUEL Technology Pvt Ltd

(2014-05 - 2019-01)

• Submit electronic claims and follow up on unpaid claims
• Perform insurance verification and ensure billing accuracy
• Enter patient data into billing systems and maintain records
• Investigate, appeal, and resolve denied or rejected claims
• Process payments and generate patient invoices
• Communicate with patients regarding billing inquiries
• Improve cash flow through timely submission of clean claims

Bachelor of Arts - BA - University of Sargodha (2017)

ICS APS&C (2017)

High School Diploma - Government High School (2009)