Inga Svintradze

Experienced Medical Billing and Revenue Cycle Specialist with 16+ years of healthcare billing, accounts receivable, claims management, and reimbursement experience across primary care, specialty practices, and hospital inpatient/outpatient environments. Expertise in analyzing underpayments, insurance denials, EOBs, payer correspondence, and claim adjudication issues to identify root causes and recover lost revenue. Strong understanding of healthcare reimbursement, payer requirements, CPT, HCPCS, ICD-10-CM coding, CMS-1500 claims, medical terminology, and revenue cycle processes.

Experienced working with Medicare, Medicaid, Medicare Advantage, commercial payers, HMO/PPO plans, managed care contracts, and capitated arrangements. Proven ability to resolve complex claim issues involving coding errors, medical necessity denials, incorrect payment processing, bundling edits, eligibility issues, and payer discrepancies. Highly organized, analytical professional with strong communication skills and extensive experience collaborating with providers, payers, patients, and internal teams in remote healthcare environments.

Medical Billing & Revenue Cycle Specialist - Primary Care at Home

(2018-01)

• Manage full-cycle medical billing operations including claim preparation, submission, payment posting, AR follow-up, denial resolution, and account reconciliation.
• Review insurance EOBs, ERAs, and payer correspondence to identify underpayments, incorrect reimbursements, and denial trends.
• Analyze claim payment variances by comparing billed charges, payer allowances, contractual expectations, and reimbursement policies.
• Research and resolve denied claims related to coding issues, medical necessity, eligibility, incorrect payer processing, and missing documentation.
• Prepare appeals and reconsiderations with supporting documentation to recover denied and underpaid claims.
• Follow up with Medicare, Medicaid, Medicare Advantage, and commercial insurance carriers regarding unpaid and incorrectly processed claims.
• Correct claims involving CPT, ICD-10-CM, HCPCS codes, modifiers, diagnosis sequencing, and payer-specific requirements.
• Manage patient balances, payment inquiries, and account resolution while providing excellent customer service.
• Maintain detailed documentation of payer communication, claim status, resolution steps, and follow-up activities.
• Utilize payer portals and clearinghouses including Avility, Office Ally, and SPOT for claim investigation and status updates.

Medical Billing Specialist - Florida Lung, Asthma & Sleep Specialists

(2014-01 - 2018-12)

• Managed physician billing for pulmonology services in office, hospital inpatient, and outpatient settings.
• Reviewed claims for accuracy prior to submission, ensuring correct CPT, ICD-10-CM, HCPCS coding, modifiers, and diagnosis selection.
• Investigated insurance denials and payment discrepancies to determine corrective action.
• Worked with Medicare, Medicaid, and commercial insurance plans to resolve outstanding AR balances.
• Reviewed EOBs to identify denial reasons, underpayments, bundling issues, and incorrect payer decisions.
• Assisted with appeals, claim corrections, and documentation requests to maximize reimbursement.
• Supported compliance with payer guidelines, federal regulations, and healthcare billing requirements.

Medical Billing Specialist - Home Physicians Group

(2008-01 - 2014-12)

• Performed medical billing, insurance follow-up, payment posting, and accounts receivable management.
• Submitted electronic and paper claims while ensuring accuracy and completeness.
• Verified insurance eligibility and benefits prior to services.
• Researched unpaid claims and communicated with insurance companies to resolve outstanding balances.
• Posted insurance and patient payments and performed reconciliation activities.
• Maintained accurate billing records while meeting productivity and quality goals.

Bachelor of Science - Mathematics - Akaki Tsereteli State University