Reliable billing professional with a strong background in medical claims, prior authorization, and account reconciliation. Experienced in resolving discrepancies, following up on unpaid claims, and working with providers and payers to improve billing accuracy. Ready to support efficient revenue cycle performance and patient billing service.
Overview
1
1
Certification
8
8
years of professional experience
Work History
Medical Biller
Mindseeker - Capital Health
Trenton, New Jersey
10.2025 - Current
Reviewed and submitted medical claims for compliance with regulations and guidelines.
Coordinated follow-ups on denied claims with payers and providers to expedite resolution and improve claims processing.
Worked with healthcare providers to fix billing discrepancies and clarify patient information.
Resolved billing questions from patients and insurance representatives to ensure accurate information and enhance patient satisfaction.
Updated patient records and billing notes in secure systems.
Reconciled payments, adjustments, and account balances.
Participated in team meetings to address challenges and contribute to development of effective solutions.
Medical Billing Specialist
Community Based Care (Remote)
Raleigh, North Carolina
08.2023 - 06.2025
Prepared and submitted insurance claims to Medicaid, Medicare, and private carriers.
Reviewed information for accuracy, checked eligibility, and verified insurance coverage for services.
Followed up on unpaid claims with patients and insurance companies.
Resolved claim denials and corrected issues for resubmission.
Created invoices and posted insurance and patient payments into EHR.
Supported billing operations for health insurance companies, patients, and healthcare providers.
Created spreadsheets for management needs and reporting support.
Medical Biller
Miami Dade Medical Billing (Remote)
Miami, Florida
03.2021 - 08.2023
Submitted medical billing claims to multiple insurance carriers.
Followed up with insurance carriers to check claim status for Medicaid and pharmacy claims, while verifying member information.
Communicated with patients by inbound and outbound calls to answer medical billing questions; handled data entry, customer service, filing, claim appeals, and payment posting.
Worked with insurance carriers and providers on prior authorization requests, reviewing medical necessity and coverage details for patients.
Submitted authorizations by email, fax, or mail, while supporting multiple specialties and processing CMS 1500 and UB-04 claim forms.
Escalation Representative
IQVIA
Troy Hills, NJ
09.2020 - 03.2021
Managed inbound and outbound calls for escalation claims, ensuring timely resolution for customer inquiries.
Processed escalation claims and communicated updates to pharmacy representatives and other departments to facilitate seamless claim handling.
Reviewed claim details, including name, address, and medications, before submitting.
Investigated customer complaints to identify root causes, contributing to improved resolution strategies.
Documented detailed reports of all escalations and resolutions.
Call Center Agent
Alorica
Miami , Florida
04.2019 - 08.2020
Supported customers with clear, concise communication to improve understanding.
Assisted clients with billing, account, and order inquiries in a timely manner.
Found root causes of customer issues and carried out effective solutions.
Kept accurate records of customer inquiries and resolutions in database.
Office Manager
292 Investments
Miami, Florida
05.2018 - 04.2019
Supported daily operations by maintaining company protocols for smooth workflow for properties in Section 8 housing.
Helped create and update office policies and procedures.
Answer phone calls, respond to emails and manage all paperwork required.
Education
Certificate - Certification in Medical Billing And Coding
Experating
Online
High School Diploma -
Felix Varela
Miami, FL
06-2017
Skills
Medical claims processing
Claims denial management
Insurance verification
Eligibility verification
Prior authorization
Claim review
Payment posting
Accounts reconciliation
Office administration
EHR systems
Medical terminology
Problem solving
Certification
Certification in Medical Billing and Coding
Timeline
Medical Biller
Mindseeker - Capital Health
10.2025 - Current
Medical Billing Specialist
Community Based Care (Remote)
08.2023 - 06.2025
Medical Biller
Miami Dade Medical Billing (Remote)
03.2021 - 08.2023
Escalation Representative
IQVIA
09.2020 - 03.2021
Call Center Agent
Alorica
04.2019 - 08.2020
Office Manager
292 Investments
05.2018 - 04.2019
Certificate - Certification in Medical Billing And Coding