Medical Biller/RCM Specialist

Overview

Looking for any work (8 hours/day)

at $4.98/hour ($960.00/month)

Bachelor's degree

Last Active

June 7th, 2026 (3 days ago)

Member Since

February 1st, 2026

Profile Description

Experienced Revenue Cycle Management Team Leader specializing in Prior Authorization, Charge Entry, Claims Submission, and Denial Management within a fast-paced healthcare BPO environment. Proven ability to ensure accurate and compliant medical billing processes from patient intake to claim resolution, with strong attention to detail and deep understanding of payer requirements.

Skilled in reviewing and validating patient information, medical documentation, and insurance details to ensure clean claim submission and reduce denials. Experienced in handling prior authorizations through payer portals, eFax, and direct coordination with insurance companies, case managers, and provider offices.

Strong background in identifying billing errors, correcting coding inconsistencies (ICD-10, CPT, HCPCS), and performing pre-billing validation to improve reimbursement outcomes. Adept at monitoring denied and unpaid claims, conducting root-cause analysis, and resubmitting corrected claims efficiently while maintaining compliance with HIPAA regulations.

Proficient in using payer portals such as Availity, UnitedHealthcare, Aetna, and BlueCross BlueShield, as well as CRM systems like Salesforce. Known for strong leadership, problem-solving skills, and the ability to guide teams toward accuracy, efficiency, and performance targets in revenue cycle operations.