Medical Biller, Project Manager|15 Yrs BPO Experience

Overview

Looking for full-time work (8 hours/day)

at $9.46/hour ($1,824.00/month)

Bachelors degree

Last Active

July 2nd, 2026 (6 days ago)

Member Since

December 10th, 2017

Profile Description

With more than 15 years of experience in Business Process Outsourcing, my core competencies are as follows:

Medical Billing
• Generates and analyzes monthly billing statements for accuracy
• Processes accounts receivable billing for various communities or generate ageing reports
• Analyze Explanation of Benefits (EOB) forms to ensure insurance companies have paid for charges 
• Review remits and payer correspondence in the course of performing account follow up and escalate any identified issues to the appropriate area for review and response to expedite claim resolution
• Ensure billing of services is handled and paid correctly
• Call insurance companies for any discrepancies in payments, obtain pre-authorization or referrals if necessary in order to get the claim paid
•Research denied claims and follow up unpaid claims to insurance companies or  appropriate parties
• Monitor charges and payment process
• Denials Management
• Collect and process information needed to fulfill medical insurance and resolve billing issues which includes reconciling of outstanding and negative balances showing on each of the assigned facilities
• Prepare, review, and transmit claims

Project Management
• Meet with stakeholders and oversee projects
• Build a Project Plan, Monitor Project Progress and Set Deadlines
•Provide updates to stakeholders during a weekly business review
•Issue Resolution
•Performance Evaluation
• Help maintain a list of contacts to be vetted via various talent resource online platforms and provide agency with responses to discuss next steps.
• Build a list of prospects to market and send proposals to
• Request for Proposal (RFPs/ RFIs/RFQs)
• Budget/ Funds Management

Training and Quality:
• Facilitate new hire training and equip trainees with basic and advance skills for support
• Communicate with Clients regarding training endorsement/ fallout
• Conduct intervention/ refresher training for new product and process updates
• Do analysis on contact drivers which affects organizational targets (TNA)
• Develop/ update training modules
• Create/ Update Adherence Reports and Evaluation Tool used by
trainers
• Coordinate with workforce regarding Abandon Rate projection
• Coordinate with HR/ Recruitment for New Hire Quality and Policies
• Standardize processes to be used by Operations/Delivery
• Design flowchart for operational processes using different platforms
• Panel for mock demo of aspiring trainers
• Oversee junior trainers in the same LOB (Level of Business)
• Assign responsibilities/ shifts to different trainers to ensure coverage and facility