Joyce Mbilika Museteka
Flowery Branch,GA
Summary
AR Billing Account Manager with proven expertise in optimizing revenue cycle operations and improving cash flow. Skilled in EHR systems and CPT/ICD-10 guidelines, with a strong track record in training teams and resolving complex billing issues. Committed to ensuring compliance and fostering interdepartmental collaboration for enhanced operational efficiency.
Overview
8
8
years of professional experience
Work History
AR Billing Account Manager
Vivo Infusion
, OH
01.2024 - 07.2025
- Prepared and submitted insurance claims using electronic health and billing system
- Posted insurance payments, reconciled deposits, and maintained accurate billing records
- Tracked claim status and resolved rejections and denials within required timeframes
- Reviewed Verification of Benefits and communicated important coverage information with providers and patients using plain language
- Set up and managed payment plans as needed
- Obtained referrals and insurance authorizations from payors as needed.
- Reviewed clinician documentation to ensure accurate billing and coding
- Periodically reviewed and updated knowledge base regarding payer policies related to clinic’s billed services
- Maintain organized billing records for auditing and reporting
- Identified any billing inefficiencies and recommended improvements
- Monitored authorization reports and sent reminders to clinicians when additional visits and prior authorizations were needed.
- Entered new client basic demographic information into billing system, as well as insurance and authorizations.
- Maintained detailed records of claim submissions, correspondences and resolutions
- Processed patient and/or insurance refunds as needed
- Communicated with patients to resolve account issues and secure payment arrangements.
- Reconciled daily batch payment
- Developed and refined billing policies and procedures in collaboration with leadership
- Answered and handled billing enquiries and phone calls from patients
- Maintained compliance with HIPAA and insurance requirements
- Adhered to and promote the practice’s mission and values
Revenue Cycle Billing Manager
Rethink
New York, New York
01.2023 - 12.2023
- Oversaw the full revenue cycle process from patient intake and charge entry to claim submission, payment posting, and collections
- Managed and supported billing teams across multiple specialties and clinic locations
- Monitored and analyzed key performance indicators (KPIs), denials, aging reports, and reimbursement trends
- Ensured compliance with payer guidelines, HIPAA, and industry regulations
- Identified operational gaps and implemented workflow improvements to optimize cash flow and minimized errors
- Provided training, mentorship, and performance oversight to billing and collections staff cycle processes
- Provided training, mentorship, and performance oversight to billing and collections staff
- Worked seamlessly across two different EHR platforms, ensuring data integrity and system efficiency
- Used payer Portal to obtain and track claims .
Clinical Reimbursement Specialist
Med-El Corporation
Durham, North Carolina
05.2021 - 12.2022
- Worked unpaid and underpaid claims from the AR Aging reports, denial file, and mailed correspondence to bring accounts to resolution .
- Run Aging reports to identify priority unpaid claims and alleviate timely filing issues when possible.
- Submitted secondary claims to payers .
- Identified recurring issues that slowed the billing processes
- Identified payer claim trends and requirements for clean claim submission.
- Worked with insurance companies, in a courteous manner, to reprocess claims that were not properly processed
- Obtained information needed to complete and re submit corrected claim information.
- Provided Medical Records to the insurance carrier.
- Composed appeal letters to accompany denial letters as required for resolution
- Investigated and worked pre-authorizations on procedures after receiving denials.
- Contacted appropriate department for resolution of coding/ billing errors.
Medical Billing and Coding Manager
Kareo
Wake Forest, North Carolina
02.2017 - 08.2020
- Oversaw the day-to-day operation of a medical billing department and staff.
- Performed Patient and Insurance report analysis and identify any trends or issues that needed to be addressed.
- Communicated trends for improvement of the cashflow with practice management team and medical providers.
- Ensured billing and coding for all current and new medical service lines were accurate and consistent.
- Created SOP's for all tasks.
- Trained and motivated billing and medical staff.
- Upheld company policies and procedures.
- Worked and managed insurance AR to resolve outstanding and denied claims.
- Submitted insurance appeals.
- Completed monthly payment posting reconciliation.
- Answered patient billing questions and concerns.
Education
Bachelor of Science - Software Development
ITT Technical Institute
Houston, TX09-2016
Associate of Applied Science - Houston, TX
Professional Career Institute
Houston08-2014
Skills
- Advance proficiency in Microsoft Office Suite, particularly Excel
- Act as a liaison between billing and departments
- Proficient in optimizing revenue cycle operations
- In-depth knowledge of federal insurance plans
- Proficient in billing software and EHR systems Epic ,R2 ,Tebra Multiple EHR systems proficient
- In-depth understanding of CPT and ICD-10 guidelines
- Ability to work independently, collaboratively in a team, able to pivot flexibly between billing and management tasks
Timeline
AR Billing Account Manager
Vivo Infusion
01.2024 - 07.2025
Revenue Cycle Billing Manager
Rethink
01.2023 - 12.2023
Clinical Reimbursement Specialist
Med-El Corporation
05.2021 - 12.2022
Medical Billing and Coding Manager
Kareo
02.2017 - 08.2020
Bachelor of Science - Software Development
ITT Technical Institute
Associate of Applied Science - Houston, TX
Professional Career Institute