Revenue Cycle Specialist (AR, Denials & Appeals)
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To secure a role in Revenue Cycle Management (including Coding, Benefits, Accounts Receivable, Billing, and Eligibility) where I can utilize my education and experience in Medical Billing, while facing new challenges.
CureMD 2023 – 2025
Handled full‑cycle claim resolution for inpatient, outpatient, hospital‑based (HB), and physician‑based (PB) billing. Performed daily AR follow‑up on denied, unpaid, and underpaid claims while working across multiple EMR systems including Epic, Athenahealth, eClinicalWorks, Cerner, MediTech, AdvanceMD, and Allscripts. Verified eligibility and benefits, obtained authorizations, and ensured accurate patient demographics.
Resolved complex coding issues involving ICD‑10, CPT, HCPCS, and modifiers, achieving a 90% payment recovery rate on denied claims. Created and submitted detailed appeals with supporting documentation, analyzed A/R reports, identified denial trends, and maintained high productivity and accuracy in a fast‑paced environment.
Insurance Service Representative (AR & Denials)
PRG 2021 – 2023
Managed daily AR follow‑up, rejections, denials, and claim edits using systems such as Epic, Office Practicum, PCC, Visiquate, Change Healthcare, Kareo, TriZetto, ECW, and Athenahealth. Coordinated benefits (COB), updated patient demographics, and handled patient balance inquiries. Submitted electronic and paper claims, resolved unauthorized deductions, and ensured accurate account balances.
Conducted research on payer policies, benefit plans, and regulations. Supported AR teams with research and project‑based tasks and prepared appeals for denied and rejected claims.
Account Resolution Specialist (Billing & Collections)
Exponere Billing 2019 – 2021
Researched and resolved discrepancies in patient accounts to ensure accurate billing. Communicated with insurance companies to verify coverage, resolve denials, and correct claim issues. Posted patient and insurance payments, managed outstanding balances, and performed collection follow‑ups.
Prepared and submitted appeals, assisted patients with billing inquiries, and ensured HIPAA‑compliant documentation. Collaborated with clinical and administrative staff to resolve billing issues and improve charge capture. Reviewed financial reports to identify trends and enhance billing processes.
BS in Mechanical Engineering – Salisbury University
