Muzamil Khalid

Results-driven Medical Billing and AR Specialist with 7+ years of RCM experience in claims processing, AR follow-up, denial management, appeals, and reimbursement. Skilled in Medicare, Medicaid, commercial billing, CPT, ICD-10, HCPCS, CMS-1500, UB04, and billing systems. Proven track record of resolving claims issues and maximizing reimbursement.

Account Receivable Specialist | Medical Billing at Fastech RCM (2022-01 – Present)

• Hands-on experience with EMR/EHR systems used for billing and record keeping such as Epic, Athena Health, e-Clinical works, Health Fusion, Advance MD, Cerner, MediTech, All Script etc.
• Proficiency navigating multiple payer portals for eligibility and claim research such as Availity, Navinet, UHC etc.
• Using different clearing house such as Availity, Change Healthcare, Trizetto and Waystar.
• Using Microsoft applications such Word, Excel, Outlook and Teams.
• Prepares monthly report for account receivables and other items assigned.
• Provide an outstanding customer service experience for patients with all correspondence Can identify coding issues such as ICD-9, ICD-10, CPT, HCPCS and Modifiers.
• Append modifiers, reassign diagnosis pointers, and understand basic medical billing coding guidelines.
• Review medical records and provider documentation to assign accurate CPT, ICD-10-CM, and HCPCS codes.
• Working with different automated billing systems. Identifies trends and any problems with particular payers and reports findings to supervising staff.
• Experience with payer contract negotiations and reimbursement methodologies.
• Achieving daily productivity and quality targets with best results. Have the ability to find the denials root cause and to fix it.
• Working with Medicare/ Medicaid, Commercial, Third Party, W/C and Managed Care Plans etc.
• Handling multiple clients with different specialties.
• Making insurance calls for follow up, claims reprocessing and negotiation.
• Contact payers to clarify denials and determine next steps (corrections, resubmission, or appeal).
• Drafting and submitting appeals with proper documentation. Educate patients on billing issues and payment options Obtaining the prior Authorization.
• Working on Reversals, Refunds and Recoupments. Working aged accounts buckets such as 60, 90 and 120 days' buckets.
• Experience and knowledge of Windows-based software required, Microsoft Windows, Outlook, Excel, Teams and Access.
• Making the AR, collection report, Payments and Charges reports.
• Sending problematic claims list to clients for the missing information and approvals.
• Resubmit accurate and timely claims in formats including, but not limited to, CMS-1500 and UB-04.
• Utilize various resources to determine patient's eligibility, benefits, and health plan confirmation.

Denial Managment Specialist at Exponere (2020-01 – 2022-01)

• Managed the full denial management lifecycle including identification, investigation, appeal submission, and resolution of denied claims across Medicare, Medicaid, and commercial payers to ensure maximum reimbursement and minimize revenue loss
• Conducted thorough root cause analysis of denied claims by reviewing EOBs, remittance advice, and payer explanation codes, implementing corrective action plans to address systemic billing, coding, and authorization errors.
• Prepared and submitted comprehensive appeal packages with supporting clinical documentation, medical records, and payer-specific justifications within required timelines to overturn denied and underpaid claims.
• Collaborated cross-functionally with coding, clinical, patient access, and authorization teams to resolve claim edits, correct eligibility discrepancies, and ensure proper documentation was in place prior to claim submission.
• Monitored and analyzed denial trends across multiple payer lines, generating detailed reports and presenting data-driven recommendations to leadership to reduce denial volume and improve clean claim rates.
• Maintained strict compliance with CMS regulations, payer contractual agreements, and timely filing requirements while consistently exceeding departmental KPIs in appeal success rate, denial resolution turnaround time, and accounts receivable reduction

AR Follow Up Rep at Cure MD (2019-01 – 2020-01)

• Contacted insurance payers via phone and online portals to follow up on outstanding claims
• Worked AR aging reports to prioritize and resolve unpaid and denied claims
• Resubmitted corrected claims and appeals for incorrectly processed or underpaid claims
• Documented all follow-up activity and call notes in the billing system
• Verified patient eligibility and benefits to resolve coverage-related claim issues
• Reviewed EOBs and remittance advice to identify and resolve payment discrepancies
• Coordinated with coding and clinical teams to resolve claim edits and rejections
• Met departmental productivity and collection goals consistently
• Maintained knowledge of payer guidelines and timely filing requirements
• Worked Medicare, Medicaid, and commercial payer accounts
• Ability to identify and correct medical billing errors.

High School Diploma in Computer Science (2012-01 – 2014-01)