Experienced Medical Biller with expertise in insurance claims processing, claim follow-up, denial management, and revenue cycle operations. Proven ability to manage complex billing workflows, including Workers' Compensation billing and Well-Child Check claims, while ensuring accurate claim submission and timely reimbursement. Highly knowledgeable in Medicare, Medicaid, Medicaid Managed Care, and Texas-based commercial insurance plans. Skilled in eligibility verification, benefits coordination, prior authorization review, claims appeals, and denial resolution. Proficient in utilizing payer portals and billing systems to investigate and resolve billing discrepancies, maximize reimbursements, and reduce accounts receivable. Strong understanding of HIPAA regulations and healthcare compliance standards, ensuring the confidentiality, integrity, and security of protected health information (PHI) in all billing and administrative processes. Detail-oriented and results-driven professional committed to maintaining compliance with payer guidelines and delivering efficient, accurate, and high-quality billing services.
