Summary
Work History
Education
Skills
Timeline
Generic

First Last

City of Angels,ST

Summary

Detail-oriented RCM specialist with hands-on experience reducing claim denials, resolving billing errors, and ensuring payer compliance. Strong knowledge of healthcare reimbursement, QA procedures, and clearinghouse workflows.

Work History

Remote Revenue Cycle QA Specialist

Company Name
08.2025 - 08.2025
  • Reduced insurance denials by enforcing QA policies during billing scrubs.
  • Identified recurring claim issues and collaborated with coders to resolve them.
  • Led internal audit reviews to ensure billing compliance with payer regulations.
  • Trained center staff on claim accuracy and policy updates.
  • Flagged clearinghouse rejections and corrected them within 24 hours.
  • Participated in weekly RCM meetings to share process improvement strategies.

Medical Billing Coordinator

Company Name
08.2025 - 08.2025
  • Processed high-volume claims while maintaining 98% clean claim rate.
  • Resolved billing discrepancies to secure timely reimbursement from commercial and Medicaid payers.
  • Maintained up-to-date knowledge of CPT and ICD-10 codes.
  • Assisted with system upgrades for billing platform and QA tracking tools.
  • Collaborated with QA and appeals teams to correct and resubmit denied claims.
  • Supported ad hoc RCM projects including payer audits and compliance reviews.

Education

Degree Earned -

School Name
City, St
08.2025 - 08.2025

Skills

  • Revenue Cycle Management
  • Medical Billing & Coding
  • QA Review & Auditing
  • Clearinghouse Submission
  • Denial Management
  • Healthcare Compliance
  • Claim Scrubbing
  • CPT & ICD-10 Knowledge
  • Payer Policy Interpretation
  • Insurance Verification
  • Process Improvement
  • Microsoft Excel (RCM reports)

Timeline

Degree Earned -

School Name
08.2025 - 08.2025

Remote Revenue Cycle QA Specialist

Company Name
08.2025 - 08.2025

Medical Billing Coordinator

Company Name
08.2025 - 08.2025
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