Vicki Mack

Senior Medical Biller / AR Follow Up Representative - HGS EBOS, LLC - Princeton, NJ

(2014-02 - 2023-06)

Reviewed and interpreted EOBs to identify underpayments, contractual discrepancies, and denial reasons, driving targeted appeal strategies that maximized reimbursement.
Recovered substantial underpaid revenue by building clinically supported appeals grounded in contract terms, consistently overturning complex insurance denials.
Leveraged payer portals — Cigna, UHC, Aetna, BCBS, and Navinet — to monitor claim status and intervene proactively before accounts aged unnecessarily.
Reduced resubmission cycles by pinpointing root causes of recurring denials and implementing corrective measures that improved claim acceptance outcomes.
Prepared and presented AR aging reports to management, highlighting denial trends and recommending workflow improvements to reduce outstanding balances.
Reconciled client payments monthly, ensuring accurate account balances and resolving discrepancies in a timely manner.
Posted insurance payments and managed recoupments accurately, ensuring proper allocation and resolution of balance discrepancies.
Generated and distributed monthly patient statements, ensuring accuracy and compliance with billing requirements.
Collaborated with internal teams and client personnel to resolve claim issues and streamline the AR follow-up process.
Accessed EMRs (Meditech, Cerner) to retrieve supporting medical documentation for appeals and claim resubmissions.
Sustained zero HIPAA violations throughout tenure by upholding rigorous data integrity and compliance standards.

Medical Biller (Temporary) - Medi-Corp - Cranford, NJ

(2013-03 - 2013-05)

Submitted accurate physician claims electronically and via hard copy, minimizing rejections from day one.
Reviewed EOBs to identify underpaid and partially paid claims; crafted appeals supported by contract language to maximize provider revenue.
Identified and corrected missing or invalid claim data, resubmitting corrected claims with minimal turnaround time.

Medical Biller / AR Follow Up - East Orange General Hospital - East Orange, NJ

(2003-07 - 2012-11)

Reviewed and interpreted EOBs across Medicaid, Commercial, and other payer types to identify discrepancies and support accurate appeals and adjustments.
Improved net collections by submitting accurate claims to Medicaid and Commercial payers, minimizing rejected and denied claims.
Posted insurance payments and processed recoupments, maintaining accurate account reconciliation across all payer types.
Expanded billing capabilities across Behavioral Health, PIP, and Workers' Compensation, broadening revenue recovery across all service lines.
Strengthened audit readiness by producing precise, HIPAA-compliant documentation for Medicare and Medicaid regulatory reviews.

Medical Biller - Trinitas Hospital - Elizabeth, NJ

(2001-02 - 2003-03)

Improved clean claim rates by proactively identifying and correcting billing errors prior to submission, reducing denial rates across Medicaid accounts.
Reviewed EOBs to validate payment accuracy and identify discrepancies requiring correction or appeal.
Recovered aged receivables by submitting well-documented appeals with clinical records and executing appropriate adjustments and write-offs.

About