Sheila Manaktola
Veradigm/Allscripts/CHMB
San Marcos,CA
14
years of professional experience
Experienced medical billing coordinator with 14+ years of success in claims processing, denial resolution, and accounts receivable management. Known for HIPAA compliance, accurate payment posting, and improving reimbursement through clean claims and strong payer follow-up.
Work History
Medical Billing Coordinator-Remote
11 Years 10 Months- Resolved denied claims by analyzing EOBs, identifying root causes, and resubmitting clean claims promptly.
- Monitored accounts receivable follow-up, contacting payers to expedite outstanding claims and payment resolution.
- Coordinated claim submission workflows, verifying insurance details and correcting billing edits before transmission.
- Posted payments accurately in practice management systems, reconciling remittances and patient account balances.
- Processed claim denials and executed appeals with a high degree of accuracy, leading to improved reimbursement outcomes.
- Ensured strict adherence to payer guidelines and maintained comprehensive documentation.
- Reviewed charge capture and coding discrepancies, partnering with clinical teams to improve billing accuracy.
- Maintained compliance with HIPAA requirements, payer guidelines, and internal revenue cycle procedures.
- Trained billing staff on denial trends, claim corrections, and efficient use of billing software tools.
- Streamlined billing workflows by standardizing documentation, reducing rework, and improving account turnaround consistency.
Medical Biller/Senior Accounts Receivable Specialist
2 Years 1 Month- Reviewed coding, demographics, and documentation for billing accuracy before claim release.
- Tracked denied claims, identified root causes, and resubmitted clean claims promptly.
- Managed insurance claim submissions and corrected rejects through clearinghouse workflows.
- Posted payments, adjustments, and EOB details into billing system with precision.
- Reconciled patient accounts and resolved outstanding balances through detailed AR follow-up.
- Coordinated eligibility verification and authorization support for complex billing cases.
- Interpreted payer guidelines to reduce recurring claim errors and billing delays.
- Mentored billing staff on claim processing, denial resolution, and account maintenance.
- Verified patients' insurance to determine eligibility.
Education
Medical Billing - Medical Billing And Coding
Skills
Claims processing proficiency
Revenue cycle optimization
Healthcare reimbursement
ICD-10 knowledge
HIPAA compliance
Billing management
Accounts receivable management
Medical office software proficiency
Process improvement
Customer service
Team collaboration
Timeline
Medical Billing Coordinator-Remote
Veradigm/Allscripts/CHMB
08.2013 - 06.2025Read More
Medical Biller/Senior Accounts Receivable Specialist
ADS
06.2011 - 07.2013Read More
UEI
Medical Billing from Medical Billing And Coding
Read More