Medical Virtual Assisstant

I have experience processing medical claims accurately and efficiently, ensuring compliance with insurance policies, coding standards (ICD-10, CPT, HCPCS), and HIPAA regulations. I am skilled in working with electronic health records (EHR), submitting claims to insurance companies, following up on unpaid claims, and resolving billing discrepancies to support timely reimbursement and maintain financial accuracy.

I have comprehensive experience managing the full spectrum of revenue cycle processes, from patient registration and insurance verification to coding, billing, payment posting, denial management, and collections. I’m skilled in optimizing workflows, ensuring compliance with healthcare regulations, and improving key performance indicators such as clean claim rates, days in A/R, and overall reimbursement. My work has consistently contributed to operational efficiency and financial health across healthcare settings.

I have hands-on experience in denial management, focusing on identifying, analyzing, and resolving claim denials to maximize revenue and reduce accounts receivable days. My responsibilities included reviewing explanation of benefits (EOBs), correcting and resubmitting denied claims, appealing unfavorable decisions, and collaborating with payers and internal teams to prevent future denials through root cause analysis and process improvements.

I have experience overseeing the accounts receivable process, ensuring timely and accurate billing, collections, and account reconciliation. I’ve led a team in managing customer accounts, resolving discrepancies, and improving cash flow through effective follow-up and process optimization. I am skilled in financial reporting, aging analysis, and maintaining strong client relationships while ensuring compliance with company policies and accounting standards.

I have experience providing exceptional customer support in fast-paced environments, handling inquiries, resolving issues, and ensuring customer satisfaction through clear communication and problem-solving. I’m skilled in using CRM systems, managing multiple channels (phone, email, chat), and maintaining a professional and empathetic approach to every customer interaction.

I have experience monitoring and evaluating healthcare processes to ensure compliance with quality standards, regulatory requirements, and best practices. My role involved analyzing clinical data, identifying trends, supporting performance improvement initiatives, and collaborating with cross-functional teams to enhance patient safety and care outcomes. I’m proficient in quality reporting tools, audits, and root cause analysis.