Analytical and detail-oriented Medical Claims and Revenue Cycle professional with experience researching insurance claim denials, resolving reimbursement issues, coordinating benefits, and reviewing Medicare, Medicaid, and commercial insurance claims. Skilled in claim investigation, payer follow-up, denial resolution, EOB interpretation, and medical billing processes.
Work History
Medical Biller, Accounts Receivable
11 Months
Alli Management Solutions | 09.2025 - Current
Review insurance claims to identify reimbursement delays, billing discrepancies, and denial trends.
Investigate Medicare, Medicaid, commercial insurance, and managed care claim denials.
Research payer policies to determine appropriate claim corrections and next steps.
Resolve Coordination of Benefits (COB) issues between primary and secondary insurance carriers.
Submit corrected claims and support appeal preparation when appropriate.
Contact insurance carriers to resolve claim status, payment issues, authorization questions, and billing edits.
Reviewed Explanation of Benefits (EOBs) to determine appropriate claim corrections.