Results-driven Medical Insurance and Revenue Cycle Specialist with 13+ years of experience supporting U.S. healthcare operations across insurance verification, prior authorizations, revenue cycle management, medical billing, claims processing, denial resolution, provider services, and credentialing. Extensive experience working with Medicare, Medicaid, commercial insurance, and workers' compensation plans in high-volume healthcare environments.
Proven ability to manage end-to-end authorization and billing workflows, review clinical documentation and medical necessity requirements, resolve payer issues, and support reimbursement processes. Recognized for exceeding productivity goals, maintaining excellent quality scores, and supporting operational improvements through SME and training responsibilities.
Verified
