Jun 2023 – May 2024 · 11 mos · California, United States · Remote

• Processed and submitted electronic and paper claims to Medicare, Medicaid, and
• commercial insurance carriers in accordance with payer-specific guidelines
•  Verified patient insurance coverage and obtained prior authorizations or referrals
• when required
•  Accurately entered patient demographics, CPT/ICD-10 codes, modifiers, and
• charges into the billing system
•  Researched and resolved claim rejections, denials, and underpayments to maximize
• reimbursement
•  Conducted account follow-up with insurance companies and patients to ensure
• timely payment
•  Generated patient statements and responded to billing inquiries professionally and
• promptly
•  Collaborated with coding, collections, and front office teams to improve revenue
• cycle workflows
•  Maintained compliance with HIPAA and payer-specific billing regulations
•  Utilized billing software (e.g., [insert EHR system]) and clearinghouse platforms to
• manage claims and remittances
•  Consistently met productivity and accuracy goals in a high-volume environment
• P R OF E S S I O NA L P R OF I L E
• Results-driven and detail-oriented Revenue Cycle Specialist with over 10 years of
• progressive experience in healthcare billing, payment posting, collections, and
• reimbursement processes. Proven track record of success in supervisory and lead
• roles, driving team performance, streamlining revenue operations, and ensuring
• compliance with industry regulations. Adept at managing front-end to back-end
• revenue cycle functions, including patient billing, claims processing, denial
• management, and payment posting. Recognized for strong leadership, effective
• communication, and the ability to train and mentor staff to exceed departmental
• goals. Committed to optimizing financial outcomes while delivering exceptional
• service in a fast-paced healthcare environment.

May 2021 – Jun 2024 · 3 yrs 1 mo · United States · Remote

• Managed and tracked all active Letters of Protection (LOPs) for personal injury patients in
• coordination with law firms and medical providers
•  Verified LOP documentation, ensured signatures were in place, and maintained compliance with
• legal and company protocols
•  Communicated directly with attorneys, patients, and providers to facilitate treatment plans, payment
• arrangements, and legal case updates
•  Monitored the status of personal injury cases to ensure timely resolution and accurate billing followup
•  Submitted personal injury claims and medical documentation to attorneys for settlement processing
•  Coordinated pre-authorizations, medical records, and billing statements related to LOP cases
•  Tracked accounts receivable, followed up on outstanding balances, and negotiated settlements
• when appropriate
•  Ensured HIPAA compliance and maintained confidentiality when handling patient and legal
• information
•  Provided support to internal billing teams with LOP-specific payment posting, claim reprocessing,
• and reconciliation
•  Created and maintained detailed logs and reports for all active and resolved LOP cases

Nov 2016 – May 2022 · 5 yrs 6 mos · United States · Hybrid

• Supervised daily operations of the personal injury department within a high-volume pain
• management clinic, ensuring efficient patient flow, timely documentation, and coordinated care
•  Oversaw a team of LOP coordinators, billing staff, and front-desk personnel handling personal
• injury cases, providing leadership, training, and performance evaluations
•  Managed all aspects of LOP (Letter of Protection) case processing, from intake to settlement,
• including verifying attorney agreements and securing necessary legal documentation
•  Acted as the primary point of contact for attorneys, patients, and providers regarding case status,
• treatment plans, and billing inquiries
•  Ensured accurate and timely submission of bills and supporting medical records to legal
• representatives for case settlement
•  Monitored accounts receivable and followed up on outstanding LOP balances to meet monthly
• financial goals
•  Collaborated with clinical staff to align treatment protocols with legal case timelines and ensure
• proper medical documentation
•  Maintained HIPAA compliance and upheld patient confidentiality across all communications and
• records
•  Created and implemented department procedures to improve workflow, enhance accuracy, and
• ensure legal and regulatory compliance
•  Generated weekly and monthly reports on case volume, collections, and aging accounts for
• executive leadership