Ruth Joel
Richmond,TX
Summary
Detail-oriented Healthcare Revenue Cycle Specialist with expertise in home infusion billing, pediatric billing, claims management, payer appeals, AR resolution, and workflow optimization. Strong analytical background with a Master’s degree in Health Administration and extensive experience across specialty pharmacy, pediatrics, and hospice/facility billing. Skilled in improving reimbursement accuracy, reducing aging AR, and supporting cross-functional clinical and billing teams.
Overview
2
2
years of professional experience
1
1
Certification
Work History
Billing Coordinator (Pediatrics & School-Based Services)
Continuum Pediatric Nursing
04.2025 - Current
- Manage pediatric and school-based billing workflows using KanTime and payer portals.
- Perform claim scrubbing, corrections, and submissions for Medicaid, commercial payers, and school districts.
- Conduct AR follow-up, resolve denials, and improve documentation accuracy to reduce rejections.
- Complete payment posting, adjustments, reconciliation, and account balancing.
- Collaborate with nurses, clinicians, school administrators, and payer representatives to ensure compliant documentation and timely reimbursement.
- Remote
Revenue Cycle / Collections Specialist (Home Infusion Specialty)
CSI Pharmacy
01.2025 - Current
- Manage full revenue cycle for high-dollar home infusion therapy claims, ensuring accurate billing and payer compliance.
- Perform eligibility verification, benefits investigation, and prior authorizations across major payers.
- Submit and track claims through Waystar, Availity, and payer portals; resolve rejections involving NDCs, J-codes, and infusion units.
- Prepare reconsiderations, corrected claims, and detailed appeal letters to overturn denials.
- Collaborate with pharmacy teams, nursing coordination, and patient services to ensure accurate documentation.
- Monitor aging AR, identify payer trends, and reduce outstanding balances through targeted follow-up.
- Remote
Collections Specialist
CarepathRx
08.2023 - 01.2025
- Processed denials, rejections, and claim corrections across major insurance plans.
- Prepared detailed appeal summaries and submitted medical documentation to support medical necessity cases.
- Managed hospice and facility billing workflows, prior authorizations, and payer communication.
- Maintained audit-ready documentation and accurate AR aging updates.
- Remote
Education
Master of Health Administration (MHA) - undefined
Webster University
Orlando, FLBachelor of Science - Genetics & Biotechnology
University of Calabar
NigeriaSkills
- Revenue Cycle Management (RCM)
- Home Infusion Billing
- Pediatric/School-Based Billing
- AR & Collections
- Appeals & Denials
- Prior Authorizations
- Eligibility Verification
- CPT/HCPCS/ICD-10
- Payment Posting
- CareTend
- KanTime
- Forcura
- Waystar
- Availity
- AlayaCare
- Process Improvement
- Payer Portal Management
Certification
- CPR/AED Certification
- Customer Service Relationship Management
- Human Resources Management
- NEBOSH (Health & Safety)
- Project Management
Timeline
Billing Coordinator (Pediatrics & School-Based Services)
Continuum Pediatric Nursing
04.2025 - Current
Revenue Cycle / Collections Specialist (Home Infusion Specialty)
CSI Pharmacy
01.2025 - Current
Collections Specialist
CarepathRx
08.2023 - 01.2025
Master of Health Administration (MHA) - undefined
Webster University
Bachelor of Science - Genetics & Biotechnology
University of Calabar