Katrina Hilliard

Results-driven Certified Medical Biller and Claims Professional with over 11 years of experience in revenue cycle management, denial analysis, and healthcare dispute resolution. Proven track record in navigating complex medical claims adjudication, resolving provider balance billing issues, and ensuring strict regulatory compliance. Adept at managing out-of-network reimbursement requests and utilizing major EMR/billing systems to optimize claims processing.

Brings deep analytical skills, strong cross-functional collaboration, and a commitment to protecting the member experience within fast-paced, remote environments.

Arbitration Specialist - MPower Health - Remote

(2025-01)

• Facilitated and managed complex arbitration and dispute resolution processes between healthcare providers and insurance companies, ensuring total compliance with industry regulations.
• Analyzed and interpreted complex contractual agreements, medical records, and claims data to identify underpayments, overpayments, and processing errors.
• Collaborated closely with legal teams, healthcare professionals, and insurance representatives to gather required clinical documentation and evidence for out-of-network billing cases.
• Developed comprehensive summaries of dispute outcomes, providing leadership with actionable insights to mitigate recurring systemic billing errors and compliance gaps.

AR Specialist - Ero Health - Fort Worth, TX

(2022-09 - 2025-01)

• Audited and reconciled accounts receivable and high-volume patient billing reports to ensure accurate claim postings, balance tracking, and prompt follow-up.
• Conducted targeted outreach to insurance carriers to investigate and resolve unpaid, delayed, or denied claims, securing proper reimbursement.
• Prepared detailed monthly aging reports to support cash flow forecasting and highlight payer non-compliance trends.

Billing Analyst, Customer Financial Services - Simitree Healthcare Solutions - King Of Prussia, PA

(2020-05 - 2022-09)

• Analyzed high-volume medical claims to identify systemic discrepancies, coding errors, and underlying trends in payer claim denials.
• Initiated root cause analysis and enhanced billing workflows, increasing overall claim processing efficiency by 15%.
• Resolved intricate payment and reimbursement issues through precise, professional communication with major insurance payers and providers.

Medical Claims Analyst - Professional Medical Services - Fort Worth, TX

(2017-03 - 2019-04)

• Successfully reduced outstanding accounts receivable by 25% within a 6-month period by systematically investigating and auditing claim denials.
• Drafted and submitted highly detailed medical necessity appeals, supported by appropriate medical documentation, CPT/ICD-10 codes, and clinical notes.
• Monitored regional reimbursement patterns to catch, track, and escalate recurring provider billing or insurance adjudication issues.

Claims CSR - Esha Medical Billing - Fort Worth, TX

(2013-04 - 2017-03)

• Resolved complex patient and provider billing inquiries with empathy and discretion, significantly improving customer resolution satisfaction scores.
• Verified member coverage, confirmed eligibility, and corrected rejected claims through the Waystar clearinghouse system for clean re-submission.
• Followed up on aging, unpaid claims with payers, successfully boosting overall revenue recovery rates.

Associate of Science - Medical Coding - Ultimate Medical Academy (2015)