Muhammad Khan

Medical Billing and Revenue Cycle Specialist with 10+ years of experience supporting healthcare billing operations, insurance claims, patient accounts, A/R follow-up, denial resolution, appeals, payment reconciliation, and reimbursement research. Experienced processing and researching claims, reviewing EOB and remittance information, identifying billing discrepancies, correcting and resubmitting claims, and following up with Medicare, Medicaid, and commercial payers. Skilled in maintaining accurate patient and payer records, documenting account activity, prioritizing work queues, protecting confidential information, and meeting productivity and quality standards.

Achieved 18% improvement in A/R resolution, 10% increase in collections, 99% clean-claim performance, and 90% denied-claim recovery. Proficient in multiple EHR, billing, clearinghouse, and payer platforms, with advanced Microsoft Excel skills.

Medical Billing Specialist - Robert Half (Client: Optum360/ United Health Group) - Astoria, NY

(2026-01 - 2026-09)

• Supported high-volume healthcare accounts receivable operations for UnitedHealth Group through Optum360, researching claims, payer responses, account history, payment activity, and unresolved reimbursement issues.
• Performed daily insurance A/R follow-up, aging review, claim research, account analysis, and prioritization of outstanding balances based on account status and required follow-up.
• Reviewed patient, payer, claim, and payment information to identify billing discrepancies, reimbursement issues, payment variances, unresolved balances, and escalation needs.
• Researched payer claim status and responses to determine appropriate resolution pathways, including payment follow-up, adjustment, correction, rebilling, escalation, or patient responsibility.
• Reviewed payment postings against claims and account transactions to identify discrepancies requiring additional research and reimbursement follow-up.
• Communicated with insurance payers and internal stakeholders to clarify claim status, payment issues, billing discrepancies, delays, and outstanding reimbursement.
• Maintained detailed documentation of payer responses, account findings, payment status, actions taken, escalation activity, and required next steps.
• Utilized client systems, work queues, internal databases, reporting requirements, and healthcare technology while maintaining data accuracy and confidentiality.
• Identified recurring account issues and escalated matters requiring additional review or specialized resolution.
• Consistently met productivity, quality, documentation, accuracy, and timely follow-up expectations in a structured remote healthcare environment.
• Protected patient, insurance, payment, and claim information in accordance with HIPAA requirements.

Medical Billing & A/R Specialist - Transcure - Astoria, NY

(2023-04 - 2026-01)

• Managed medical revenue cycle activities involving insurance A/R, claims, denials, payment discrepancies, corrections, resubmissions, appeals, and reimbursement recovery.
• Researched Medicare, Medicaid, and commercial payer requirements to identify denial root causes and determine appropriate claim-resolution and reimbursement actions.
• Analyzed claim information, payer responses, EOBs, denial reasons, account history, and supporting documentation to identify reimbursement issues and appropriate next steps.
• Achieved a 99% first-pass claim rate by validating billing information, resolving claim rejections, and confirming payer requirements.
• Increased collections by 10% through aging analysis, account prioritization, timely payer follow-up, and focused resolution of outstanding balances.
• Recovered 90% of denied claims through denial root-cause analysis, payer research, corrections, resubmissions, and appeals supported by medical records and payer policies.
• Identified denial categories and underlying issues involving eligibility, coding, billing, payer processing, and other claim requirements to support appropriate resolution and routing.
• Maintained accurate documentation of denial findings, payer contacts, reference information, actions taken, escalation activity, and follow-up dates.
• Collaborated with providers, coding and billing teams, and insurance representatives to resolve complex reimbursement and claim issues.
• Researched recurring claim and payer issues to identify patterns and support process improvements in claim accuracy and reimbursement.
• Managed assigned accounts independently while meeting productivity, quality, accuracy, and timely follow-up expectations.
• Applied payer policies, insurance requirements, and billing guidelines when determining appropriate claim and account-resolution actions.

Medical Billing & Revenue Cycle Specialist - Z Med Solutions - Minneapolis, MN

(2019-01 - 2023-03)

• Managed professional and hospital revenue cycle activities from claim submission through payment, including denial resolution, payment research, corrections, resubmissions, appeals, and reimbursement follow-up.
• Improved A/R resolution by 18% through systematic payer follow-up, aging analysis, account prioritization, and resolution of outstanding reimbursement balances.
• Achieved a 99% clean claim rate by validating demographics, insurance coverage, coding, modifiers, and payer-specific requirements.
• Improved reimbursement efficiency by 15% through eligibility, benefit, and coverage validation.
• Researched and resolved ICD-10, CPT, HCPCS, and modifier discrepancies affecting claim processing, payment, and reimbursement.
• Analyzed claim and account information to identify denial root causes, reimbursement issues, coding discrepancies, payer processing problems, and required corrective actions.
• Prepared appeals using claim information and supporting clinical documentation, contributing to an 85% denial recovery rate.
• Interpreted payer policies, benefit plans, insurance requirements, and reimbursement guidelines to determine appropriate billing and claim-resolution actions.
• Reviewed pending and unpaid claims through payer response and resolution while maintaining accurate account notes, findings, and follow-up information.
• Worked with intake, coding, and billing teams to identify upstream workflow and billing issues and support accurate claim processing.
• Prioritized assigned work based on account status, aging, payer response, financial impact, and required follow-up while maintaining quality standards.

Bachelor Of Business Administration - University of Peshawar (2008-09 - 2012-11)