Wish Mo Lang

Results-driven Medical Billing & Revenue Cycle Specialist with 14+ years of experience supporting U.S. independent physician practices and multi-specialty clinics through outsourced Revenue Cycle Management (RCM) services. Extensive experience in Ambulatory Care, Pain Management, and Orthopaedics, with comprehensive knowledge of Medicare, Medicaid, Workers' Compensation, VA, TRICARE, and major Commercial payers. Proven expertise across the full revenue cycle, including insurance eligibility and benefits verification, prior authorization, claims submission, payment posting, accounts receivable follow-up, denial management, appeals, payment reconciliation, and reimbursement analysis.

Skilled in applying ICD-10-CM, CPT, HCPCS Level II, modifiers, and CMS-1500 billing standards while utilizing eClinicalWorks, Athenahealth, Prognocis, Brightree, Waystar, Availity, TriZetto, and multiple payer portals. Demonstrated success maintaining first-pass claim acceptance rates exceeding 90%, processing 300+ insurance claims and reviewing 200+ EOBs weekly while consistently meeting productivity and quality standards. Recognized for resolving complex payer issues, reducing aged accounts receivable, improving denial resolution, and maximizing reimbursement through accurate claim review, root-cause analysis, and proactive payer followup.

Known for taking ownership of complex reimbursement challenges from initial denial through final resolution while collaborating effectively with providers, coders, front-office teams, and payer representatives. Committed to improving revenue cycle performance through process improvement, revenue integrity, and accurate, compliant billing practices in fully remote healthcare environments.

Medical Biller - BASS Medical Group – Sourcefit Philippines Inc.

(2023-01)

• Insurance Verification: Verified patient insurance eligibility and benefits via Availity, insurance portals, and direct calls; accurately updated insurance and patient data in the billing system.
• Chart Review & Coding: Reviewed patient medical records and physician documentation for accuracy; identified coding discrepancies and communicated with providers for clarification.
• Claims Submission & Follow-Up: Prepared and submitted clean claims electronically and manually; monitored claim status and followed up on unpaid, rejected, denied, or underpaid claims.
• EOB Review & Denial Management: Reviewed Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs) for payment accuracy; identified denial trends and recommended corrective actions.
• Payment Posting & Reconciliation: Ensured accurate allocation of payments, adjustments, credits, and insurance overpayments; reconciled payment discrepancies from EOBs/ERAs and insurance portals.
• Appeals: Prepared and submitted appeals for denied claims with supporting documentation; collaborated with claims managers and adjusters to resolve discrepancies and dispute denials.
• Accounts Receivable: Monitored aging reports, prioritized overdue accounts, and maintained detailed documentation of collection activities and account status updates.

Assistant Billing Team Lead / Acting Billing Team Lead / Medical Biller & Coder - Anesis Spine & Pain, PLLC – AMMEX iSupport Worldwide

(2019-01 - 2023-12)

• Led, mentored, and managed the local billing team as Acting Billing Team Lead (2021) and Assistant Billing Team Lead (2022–2023).
• Verified patient insurance eligibility, benefits, authorizations, and coverage prior to services, reducing processing delays and preventing claim rejections; confirmed co-payments, deductibles, and patient financial responsibilities.
• Reviewed patient charts, encounter forms, and supporting documentation; applied correct billing codes ensuring compliance and accuracy; ensured charges matched services rendered.
• Prepared, reviewed, and submitted electronic and paper claims to insurance carriers; monitored claim status and tracked reimbursements; followed up on denied, rejected, unpaid, and delayed claims.
• Accurately posted insurance and patient payments; reconciled daily payment batches, deposits, and AR balances; ensured accurate allocation of payments, adjustments, refunds, and credits.
• Coordinated seamless communication with patients, insurance providers, and medical offices to support claims processing and eligibility verification.
• Served as Patient Service Representative (2019–2020): handled incoming calls from patients, insurance companies, and doctor's offices; coordinated patient appointments and sent reminders.

Insurance Resolution Specialist - Classic Sleepcare, LLC

(2016-01 - 2019-12)

• Resolved complex insurance claim issues by analyzing discrepancies, researching claim histories, and negotiating with insurance companies to secure appropriate reimbursements.
• Managed insurance verification ensuring accurate patient information and Coordination of Benefits (COB), significantly reducing processing delays and preventing claim rejections.
• Engaged with insurance companies via phone and portals to track claim status; maintained detailed records in Brightree for accuracy and follow-up.
• Managed patient follow-ups on outstanding balances; generated and tracked invoices; addressed patient queries regarding bills, denied claims, and CPAP equipment.

Credit & Collection Sr. Representative (WC Comp Acct) / Customer Service Sr. Rep / Customer Service Rep - AthenaHealth – Dell Int'l Services Philippines Inc.

(2009-01 - 2012-12)

• Prepared and submitted clean claims electronically and manually to insurance carriers; monitored claim status and ensured timely processing and reimbursement.
• Followed up on unpaid, rejected, denied, or underpaid claims; researched billing issues; resolved claim discrepancies efficiently; appealed denied claims with supporting documentation.
• Led and mentored new team members as Credit & Collection Sr. Representative.

General Clerk - Solid Shipping Lines

(2008-01 - 2009-12)

• Handled customers' bills of lading, prepared shipments, encoded van summary reports for shipment tracking, and computed total shipment charges based on size and weight.

Warehouseman - Zuellig Pharma Corporation

(2006-01 - 2007-12)

• Managed inventory following FIFO procedures, conducted regular inventory checks, reported damaged and expired items, and handled customer orders for timely dispatch.

Master of Divinity - Biblical Studies - TCA College, Singapore (2013-01 - 2016-12)

Bachelor of Science - Forestry – Environmental Studies - Western Mindanao State University (WMSU) (2000-01 - 2005-12)

Secondary Education - Zamboanga City Polytechnic College (1996-01 - 2000-12)