Senior Revenue Cycle Management (RCM) Specialist with over 6 years in U.S. healthcare operations, including medical billing, claims processing, insurance verification, AR management, and denial resolution. Proven expertise in managing end-to-end revenue cycle workflows, improving reimbursement outcomes, and ensuring payer compliance. Strong background in client-facing support, data analysis, and healthcare systems, including Epic, AdvancedMD, and multiple CRM platforms. Highly adaptable, detail-oriented, and skilled in process optimization and cross-functional collaboration.
Beyond healthcare, I offer strong skills in customer relations, technical support, process optimization, and business development. I am experienced with Salesforce, HubSpot, and multiple EHR/EMR systems, and I excel in both remote and hybrid work settings.
If you’re seeking a dedicated professional to optimize healthcare operations, improve customer experiences, and drive business growth, let’s connect!
Experience: 5 - 10 years
End-to-end management of billing processes including charge entry, claim submission, payment posting, and coordination with payers to ensure timely and accurate reimbursement.
Experience: 5 - 10 years
Comprehensive understanding of the full healthcare revenue cycle, from patient intake and insurance verification to coding, billing, claims processing, AR follow-ups, and final reimbursement. Skilled in optimizing workflows, reducing denials, and improving overall financial performance.
Experience: 2 - 5 years
Advanced expertise in assigning and validating accurate CPT, HCPCS, and ICD-10-CM codes based on clinical documentation, ensuring compliance with payer-specific guidelines and regulatory standards. Strong application of NCCI edits, LCD/NCD policies, and appropriate modifier usage to prevent coding errors, reduce denials, and support clean claim submission. Specialized in Infusion, Hydration, and Injection coding, including correct use of time-based billing rules, service hierarchies, and add-on codes for accurate charge capture. Conduct detailed coding validation and charge audits to identify discrepancies, undercoding, and missed revenue opportunities, ensuring audit readiness. Collaborate with providers and clinical teams to ensure documentation supports medical necessity, compliance, and successful claims adjudication.
“I have a team of 6 VA's that pretty much do everything for me”
Elishama Jiles
SEE MORE REAL RESULTSOnlinejobs.ph "ID Proof" indicates if "they are who they say they are".
It DOES NOT indicate skill level.
ID Proof scores are 0 - 99 with 99 being the best. It is calculated based on dozens of data points.
It's intended to help employers know who they're talking to is real, and not a fake identity.