Medical Virtual Assistant | US Medical Billing & AR | Prior Authorization | Denial Management

I am a Medical Billing Specialist with 10+ years of total experience in healthcare billing
and insurance claims — including 9+ years handling Philippine medical billing and insurance
(PhilHealth and HMO claims), and 1 year specializing in full-cycle US medical billing as a
Medical Virtual Assistant. In that US-focused year, I personally handled the complete revenue
cycle: eligibility verification, prior authorization, claims submission, denial management,
and accounts receivable follow-up.

This combination gives me a strong foundation in insurance and claims logic from a decade in
the industry, plus direct, current hands-on experience with US payers, US coding conventions,
and US-specific compliance requirements — so I can ramp up fast without a steep learning curve.

My core expertise includes:
• Insurance verification & eligibility checks
• Prior authorization coordination & submission
• Medical coding & charge entry (ICD-10, CPT, HCPCS)
• Claims submission & follow-up (EDI/paper)
• Denial management, appeals & root cause analysis
• Payment posting & patient billing
• AR reporting, aging analysis & performance tracking
• EHR/EMR data entry, scheduling & patient communication (Medical VA support)

I'm experienced with major EMR/EHR systems and billing clearinghouses, including Kareo and Availity. I take a proactive approach to denial prevention — identifying
trends early and working directly with clinical teams to close documentation gaps before
they turn into lost revenue.

Whether you need a dedicated full-time billing specialist, a Medical VA to manage patient-facing
admin and insurance tasks, or someone to clean up a backlogged AR, I bring reliability, attention
to detail, and a results-driven mindset to every engagement.

WHAT I'VE DONE FOR CLIENTS (US practice, Medical VA role)

Denial Reduction for a Private Clinic
Working with a solo physician practice struggling with a high volume of denied claims, I
audited their denial patterns and identified the most common root causes — including missing
prior authorizations and coding mismatches. I restructured their claims review process,
coordinated with the clinical team on documentation standards, and implemented a denial
tracking system. Within a few months, the practice saw a 20–30% reduction in denial rates,
recovering revenue that had previously been written off.

End-to-End Billing Support for a Solo Physician
I managed the full revenue cycle for a solo physician practice — insurance verification,
prior authorization, charge entry, claims submission, payment posting, and patient billing.
Using Kareo as the practice management system and Office Ally/Availity for clearinghouse
submission, I kept AR days low and ensured claims went out clean the first time, giving the
physician full confidence to focus entirely on patient care.