STOP LOSING HOURS TO INSURANCE HOLD MUSIC AND CLAIM RE-SUBMISSIONS.
As a Medical Biller focused on Revenue Cycle Management (RCM), I take the weight of claims processing off your shoulders by ensuring every patient demographic is verified and every CMS-1500 is tracked to completion. I don’t just submit claims—I manage the process so you can reclaim your time for patient care.
HOW I PROTECT YOUR CASH FLOW:
- Front-End Accuracy: Precise patient intake and insurance eligibility/benefits verification.
- Clean Claims: Meticulous claim creation, submission, and proactive tracking.
- Revenue Recovery: Diligent AR follow-up and accurate ERA/EOB payment posting.
- Software Ready: Proficient in Office Ally, Availity, and PTEverywhere (EHR/EMR).
I am a HIPAA-compliant medical biller focused on minimizing avoidable denials through meticulous follow-through and ICD-10/CPT accuracy. I am highly organized, detail-oriented, and looking for a long-term role where I can grow with your practice.
Ready to stop chasing payments? Send me a message today and let’s get your billing back on track!
Comprehensive Medical Billing Technical Index
I. Core Revenue Cycle Management (RCM) & Claims Processing:
Full Cycle Medical Billing | Front-End Billing Operations | Back-End Revenue Recovery | Claim Cycle Management | Clean Claim Rate (CCR) Optimization | CMS-1500 Claim Form Preparation | UB-04 Institutional Billing | HIPAA 5010 Transaction Standards | Electronic Data Interchange (EDI) | Clearinghouse Gateway Management | Claim Scrubbing | Manual Claim Entry | Batch Submission | Real-Time Claim Tracking | Secondary & Tertiary Claim Filing | Coordination of Benefits (COB) | Crossover Claims | Corrected Claims (Frequency Code 7) | Voided Claims (Frequency Code 8) | Timely Filing Monitoring.
II. Coding, Documentation & Medical Necessity:
ICD-10-CM (International Classification of Diseases, 10th Revision) | CPT (Current Procedural Terminology) | HCPCS Level II (Healthcare Common Procedure Coding System) | Medical Coding Compliance | Category II & III Codes | CPT Modifiers (25, 59, 95, GP, GO, GN, XP, XS, XE, XU) | Evaluation and Management (E&M) Leveling | Superbill Analysis | Encounter Form Auditing | NPI (National Provider Identifier) Type 1 & Type 2 | Taxonomy Code Verification | Place of Service (POS) Codes | Procedure-to-Diagnosis Mapping | Medical Necessity Verification | Local Coverage Determinations (LCD) | National Coverage Determinations (NCD).
III. Insurance Eligibility & Verification (Front-End):
Insurance Benefits Verification | Eligibility Checking | Primary, Secondary, and Tertiary Coverage | HMO, PPO, EPO, and POS Plan Logic | Medicare Part B | Medicaid Managed Care | Blue Cross Blue Shield (BCBS) FEP & Commercial | UnitedHealthcare (UHC) | Aetna | Cigna | Humana | Tricare | Workers' Compensation | Personal Injury Protection (PIP) | Letter of Protection (LOP) | Prior Authorization (PA) | Pre-Certification | Referral Tracking | Patient Financial Responsibility | Deductible Tracking | Co-insurance Calculation | Copay Reconciliation.
IV. Accounts Receivable (AR) & Denial Management:
AR Aging Report Management (0-30, 31-60, 61-90, 91-120+ Days) | Denial Root Cause Analysis | Rejection Resolution | Denial Management Software | Insurance Appeals (Level 1, 2, and 3) | Redetermination Requests | Reconsiderations | Fair Hearing Support | Insurance Takebacks & Offsets | Credit Balance Resolution | Unapplied Credits | Overpayment Recovery | Recoupment Management | Payer Correspondence | Insurance Representative Communication | Claims Follow-Up | Out-of-Network (OON) Negotiations.
V. Payment Posting & Financial Reconciliation:
EOB (Explanation of Benefits) Analysis | ERA (Electronic Remittance Advice) Processing | 835 Transaction Set | Electronic Payment Posting | Manual Payment Posting | Patient Statement Generation | Patient Ledger Reconciliation | Daily Deposit Balancing | Batch Reconciliation | Financial Reporting | Revenue Integrity | Write-offs & Adjustments | Contractual Allowances | Patient Collections Support | Merchant Account Integration.
VI. Software, Compliance & Systems:
Office Ally Service Center | Availity Essentials Portal | PTEverywhere Practice Management | EHR (Electronic Health Records) | EMR (Electronic Medical Records) | Patient Portals | HIPAA Privacy & Security Rules | PHI (Protected Health Information) Security | HITECH Act Compliance | Data Entry Integrity | Microsoft Excel (Formulas, VLOOKUP, Pivot Tables) | Google Workspace | Cloud-Based Billing Systems | Remote Billing Operations | Virtual Private Network (VPN) Security | Encrypted Communication.
VII. Specialized Billing Contexts:
Physical Therapy (PT) Billing | Occupational Therapy (OT) Billing | Speech-Language Pathology (SLP) Billing | Mental Health Billing | Behavioral Health (LCSW, LMFT, LPC) | ABA (Applied Behavior Analysis) | Chiropractic Billing | Solo Provider Support | Multi-Specialty Group Billing | Outpatient Rehabilitation |
Experience: 5 - 10 years
Strong attention to detail developed through administrative and medical billing training. Focused on maintaining accurate records, verifying information before submission, and following documentation standards to minimize billing errors.
Experience: Less than 6 months
Completed formal HIPAA Privacy and Security training. Knowledgeable in safeguarding PHI, maintaining confidentiality, using secure systems, and following proper data handling procedures. Applied HIPAA guidelines during medical billing practice exercises and simulations.
Experience: Less than 6 months
Trained in verifying patient insurance eligibility and benefits, including coverage status, effective dates, deductibles, copays, and plan limitations. Performed insurance verification practice using payer portals and mock scenarios as part of medical billing training.
Experience: Less than 6 months
Trained in basic accounts receivable processes, including reviewing claim statuses, identifying unpaid or underpaid claims, and understanding follow-up workflows. Familiar with EOB interpretation and common AR-related issues through hands-on billing exercises.
Experience: Less than 6 months
Completed end-to-end medical billing training covering patient demographics entry, claim creation, submission, payment posting, and basic billing workflows. Hands-on practice using medical billing software and simulated claim scenarios.
Experience: Less than 6 months
Trained in the full revenue cycle management process from patient registration and eligibility verification to claim submission, payment posting, and denial review. Understands how each stage impacts timely reimbursement.
Experience: Less than 6 months
Trained in identifying common denial reasons such as eligibility issues, missing information, and authorization errors. Familiar with basic denial resolution steps, including corrections, resubmissions, and documentation review through practice exercises.
“My Filipino specialist who is absolutely amazing..go get your OFS today!”
Eden Einav
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