Malik Waqas

RCM specialist with 8+ years of experience optimizing end-to-end revenue cycle performance. Recognized for recovering $1.2M annually, cutting AR days from 45 to 28, and driving clean claim accuracy to 98 percent through automation and payer intelligence. Deep expertise in credentialing, authorizations, coding, denials, and financial reporting across Cardiology, Orthopedics, and Multi-specialty practices.

Proven ability to design scalable workflows and guide cross-functional teams to eliminate revenue leakage and accelerate collections.

Revenue Cycle Analyst at CLOUDRCM SOLUTIONS (2022-07 – Present)

• Recovered $1.2 million annually by correcting systemic coding errors in high-volume cardiology and orthopedic claims.
• Streamlined denial management workflows, cutting AR days from 45 to 28 through automation and payer-specific rules.
• Boosted clean claim accuracy to 98% by refining clearinghouse edits and training front-office staff.
• Secured 15+ payer contracts, increasing reimbursement rates by an average of 12% across commercial plans.
• Built Excel and EHR dashboards to track provider productivity, revenue trends, and RCM performance.
• Supervised 5 team members auditing 500+ charts monthly for HIPAA compliance and documentation accuracy.
• Coordinated prior authorizations and pre-certifications to prevent avoidable denials and reimbursement delays.

Medical Billing & Coding Specialist at CODEMAX MEDICAL BILLING (2018-12 – 2022-06)

• Processed 1,500+ claims weekly while maintaining 99% accuracy in ICD-10 and CPT coding.
• Recovered $150,000+ quarterly by resolving 300+ aged claims monthly and prioritizing high-value accounts.
• Cut claim denials by 20% through pre-submission audits and accurate modifier application (25, 59, LT/RT).
• Accelerated payment posting by implementing an electronic system that reduced manual entry time by 40% and eliminated posting errors.
• Increased patient collections by 30% by streamlining statement cycles and reducing bad debt write-offs.
• Administered full-cycle billing for DME and home health services in accordance with Medicare LCD/NCD guidelines.

Credentialing & Authorization Coordinator at NEXUS HEALTHCARE SOLUTIONS (2016-12 – 2018-12)

• Enrolled 40+ providers across 25 payers, maintaining 100% compliance with CAQH and PECOS requirements.
• Decreased authorization-related denials by 90% through standardized intake procedures and eligibility checks 48 hours before appointments.
• Eliminated a 6-month enrollment backlog, releasing $200,000 in previously held claims for reimbursement.
• Overturned 75% of reviewed medical necessity denials by coordinating peer-to-peer authorization reviews.
• Updated NPI and taxonomy records in NPPES to support accurate enrollment and claims processing across multiple locations.
• Generated $10,000 in additional monthly collections by training front-desk staff on eligibility verification, benefits checks, and point-of-service collections.

Coding Training and HIPAA Compliance – Coastline College (2014 – 2015)