Expertise/Experience:
-In-depth knowledge of the U.S. medical insurance industry, including medical terminology and insurance compliance guidelines
-Skilled in analyzing and interpreting Explanation of Benefits (EOBs), including copayments, coinsurance, deductibles, and denial codes
-Specialized in payment posting for patients, insurance companies, and third-party payers (EFT, checks, credit cards, ACH)
-Experienced in posting denials and adjustments with accurate categorization.
-Strong ability to reconcile payments, ensuring alignment between actual and expected amounts, and resolving discrepancies
-Maintain precise financial records and generate regular reports for management review
-Proficient in healthcare billing systems such as eClinicalWorks, AdvancedMD, and QRS Pradigm
-Knowledgeable in navigating insurance portals for claims checking, downloading and importing 835 electronic remittance files to system.
