Medical Billing and Benefits Investigation Specialist with Healthcare and Lead G

Experienced Lead Generation Specialist responsible for assisting customers with rental property inquiries, qualifying potential clients, and coordinating customer concerns related to housing and real estate services. Skilled in communication, customer engagement, and managing client information in a fast-paced environment.

• Ensured billing accuracy while maintaining strict HIPAA compliance and Pt information in regards to medication

Medical Billing & Accounts Receivable (AR) Specialist with 3+ years of experience in specialty pharmacy. Skilled in benefits verification, insurance coordination, prior authorization, and denial management. Experienced in handling multiple US insurance plans and reviewing patient eligibility, coverage, and patient responsibility (copay, coinsurance, deductible). Proficient in AR follow-up, analyzing denied/unpaid claims, and resubmitting for timely reimbursement. Knowledgeable in EOB review, claim processing, and revenue cycle workflows. Familiar with tools such as Tebra and TherapyAppointment.

Make sure to follow the right diagnosis code by the pt medication and able to verify if the ICD required an AUTHORIZATION.

Verified patient insurance eligibility, benefits, and prior authorization requirements • Investigated deductibles, out-of-pocket maximums, copays, and co-insurance • Reviewed diagnosis codes and authorization details prior to billing • Coordinated with insurance providers and medical offices to resolve discrepancies • Ensured billing accuracy while maintaining strict HIPAA compliance