Muhammad Usman Riaz

Detail-oriented Medical Billing and Revenue Cycle Management (RCM) professional with hands-on experience in HIPAA compliance, payer-specific compliance requirements, and RCM KPI performance monitoring. Skilled in Microsoft Excel and MS Office for billing reports, data tracking, reconciliation, and performance analysis. Strong experience in customer support, patient communication, and insurance communication, including insurance verification, eligibility checks, claim status follow-up, and resolving billing-related inquiries.

Experienced in payment posting and reconciliation, denial management, appeals, claims processing, AR follow-up, claim submission, and billing documentation. Knowledgeable in ICD-10, CPT, and HCPCS coding, with a strong focus on billing accuracy, clean claims, denial reduction, successful appeals, timely reimbursement, and overall revenue cycle performance.

Senior Billing Coordinator (Remote) at Bell MedEx Medical Billing (2025-01 – Present)

• Maintained HIPAA compliance and followed payer-specific billing policies and internal compliance procedures.
• Monitored and supported key RCM KPIs, including clean claim rate, denial rate, AR aging, claim turnaround time, collection performance, accuracy, and follow-up productivity.
• Used Microsoft Excel and MS Office for billing reports, data tracking, reconciliation, performance monitoring, and administrative tasks.
• Provided professional customer support and patient communication regarding billing inquiries, account balances, insurance coverage, and payment-related issues.
• Communicated with insurance companies and payer representatives regarding eligibility, claim status, coverage, denials, underpayments, and outstanding payments.
• Verified patient insurance eligibility and benefits before services to minimize billing errors and coverage-related denials.
• Posted insurance and patient payments and performed payment reconciliation to ensure accurate account balances.
• Managed denied and rejected claims, investigated denial reasons, identified root causes, corrected errors, and resubmitted claims for proper adjudication.
• Prepared and submitted appeals for denied or underpaid claims, including reviewing denial reasons, gathering supporting documentation, correcting billing information, and submitting appeals to insurance payers.
• Followed up on submitted appeals and reconsiderations with insurance companies to monitor status and support successful resolution.
• Prepared, reviewed, and submitted insurance claims using ICD-10, CPT, and HCPCS coding systems.
• Managed Accounts Receivable (AR) follow-up and monitored outstanding claims and aging balances.
• Followed up on unpaid, pending, and underpaid claims with insurance providers to support timely reimbursement.
• Reviewed billing documentation for accuracy, completeness, and compliance before claim submission.
• Maintained accurate and confidential patient and insurance information in accordance with HIPAA requirements.
• Analysed billing, denial, appeal, and collection reports to identify issues affecting reimbursement and revenue cycle performance.

Billing Coordinator at Nobility MBS (2023-07 – 2025-04)

• Supported daily RCM operations, including claim preparation, data entry, documentation review, and account reconciliation.
• Assisted with KPI tracking related to claim processing, accuracy, follow-up, productivity, and turnaround time.
• Used Microsoft Excel and MS Office for data entry, billing reports, tracking, and reconciliation.
• Supported customer and insurance communication regarding claim status, documentation, and billing-related issues.
• Assisted with payment reconciliation, denial tracking, claim follow-up, and appeals.
• Reviewed denial reasons and assisted in preparing required documentation for claim reconsideration and appeals.
• Assisted the billing team with resolving claim processing errors and denied claims.
• Reviewed billing information for accuracy and completeness before processing.
• Maintained patient and payer information in accordance with HIPAA and confidentiality requirements.

Masters in Informatics Engineering – University of Evora (2024-09 – 2026-05)

Bachelors of Science in Computer Science – Virtual University of Pakistan (2017-09 – 2023-04)