Medical AR & Appeals Specialist | Denial Management | Revenue Cycle Expert

PROFILE DESCRIPTION

I am a dedicated Healthcare Revenue Cycle Specialist with over 4 years of experience supporting US healthcare providers in Medical Accounts Receivable, claims management, denial resolution, and appeals writing. My focus is helping practices recover lost revenue, reduce AR aging, and resolve complex insurance issues efficiently.

I have strong experience reviewing EOBs, analyzing denial codes, and communicating with insurance companies to ensure claims are processed correctly and reimbursements are maximized. I also handle insurance verification, prior authorization requests, payment posting, and post-payment audit (PPA) reviews.

I have worked with major US insurance payers including UnitedHealthcare, Aetna, Cigna Healthcare, Humana, and Blue Cross Blue Shield. I am also experienced in using payer portals such as Availity Essentials to verify eligibility, check claim status, and resolve denials.

My responsibilities include following up on unpaid claims, preparing detailed appeal letters, posting insurance and patient payments, and ensuring claims comply with payer guidelines and HIPAA regulations.

I am highly organized, detail-oriented, and comfortable managing high-volume accounts while maintaining accuracy and efficiency. My goal is always to support healthcare providers by improving revenue recovery and ensuring claims are resolved quickly and correctly.

KEY SKILLS

Medical Accounts Receivable (AR)
Revenue Cycle Management (RCM)
Medical Billing and Coding
Denial Management
Appeals Writing
Claims Follow-ups
Insurance Verification
Eligibility Verification
Prior Authorization
Payment Posting
Post Payment Audit (PPA)
EOB Analysis
HIPAA Compliance
Payer Portal Navigation