US Healthcare Senior Collection Specialist

Proficient in understanding and applying insurance guidelines and payer policies with 5+ years of experience in Revenue Cycle Management. Skilled in staying updated on industry regulations and payer-specific requirements to ensure compliance and accurate claim submissions. Experienced in analyzing policy changes, identifying their impact on claims, and effectively communicating updates to internal teams to optimize reimbursement processes.

Experienced in Revenue Cycle Management (RCM) with over 5 years of expertise in managing and resolving claim denials for healthcare providers. Skilled in analyzing denial trends, submitting appeals, communicating with payers, and ensuring accurate claim processing. Proficient in payer policy compliance, performance tracking, and collaboration with billing and coding teams to optimize reimbursement and streamline workflows.

Experienced in Claim Denial Management with 5+ years of expertise in identifying, analyzing, and resolving denied claims from US insurance payers. Skilled in submitting reconsiderations and appeals, communicating effectively with payers, and utilizing provider portals and other tools. Proficient in maintaining detailed records, collaborating with billing and coding teams, and ensuring compliance with payer policies and industry standards to maximize reimbursement and reduce denial rates.

Skilled in navigating electronic health records, managing patient data, and utilizing billing platforms to process claims, track payments, and resolve denials. Experienced in optimizing workflows, ensuring data accuracy, and leveraging software tools to enhance operational efficiency and revenue performance.

Knowledgeable in medical coding and terminology with 5+ years of experience supporting accurate claim submissions and denial management. Skilled in interpreting CPT, ICD, and HCPCS codes to ensure compliance with insurance guidelines and payer policies. Experienced in collaborating with billing and coding teams to identify and resolve coding-related issues, enhancing claim accuracy and reimbursement efficiency.

Well-versed in HIPAA compliance with 5+ years of experience ensuring the confidentiality, integrity, and security of patient health information. Skilled in adhering to privacy regulations during claim handling, data management, and payer communications. Experienced in maintaining compliance protocols and promoting best practices to safeguard sensitive information throughout the revenue cycle process.