Alfredo M.
Senior Medical Billing and Accounts Receivable Specialist
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Alfredo M. is a detail-oriented professional with a decade of experience as a Medical Billing and Accounts Receivable Specialist, primarily focused on improving billing operations and insurance claims processing. His expertise encompasses medical billing, denial management, as well as accounts receivable and revenue cycle management within the healthcare industry. Throughout his career, Alfredo has proven his ability to resolve unpaid claims efficiently, manage billing disputes, and enhance clean claim rates, ensuring accurate reimbursement from insurance providers. In his role at HealthRecon Connect Inc., he significantly reduced claim denials and improved revenue recovery. While working with Wipro Philippines, he excelled in managing patient billing services and collections. At Optum Global Solutions, Alfredo handled various aspects of accounts receivable collections and followed up on unpaid claims, maintaining compliance and accuracy. His technical proficiency includes medical billing systems, electronic medical records, and claims management platforms, supported by strong analytical skills demonstrated during his tenure as a Medical Equipment and Fax Coordinator and Patient Accounts Representative. Alfredo holds an undergraduate degree in Electrical Engineering from the University of Cebu.
Experience
Virtual Assistant – Medical Equipment and Fax Coordinator
null · 2024 — 2026Responsible for the review of medical records pertaining to equipment documentation along with the processing of incoming medical faxes with a focus on accuracy and efficiency. Ensured proper categorization of document types and filed medical documents correctly into patient records and systems. Maintained confidentiality and adhered to healthcare documentation standards while providing administrative support and managing records.Denial Management and Medical Billing Specialist
HealthRecon Connect Inc. · 2022 — 2024Conducted detailed claims analysis to reduce claim denials and rejections while initiating process improvement strategies. Aided in enhancing clean claim rates and recovering revenue from denied claims. Determined root causes of denials and executed corrective actions to mitigate future occurrences. Reviewed billing data to uncover trends, discrepancies, and delays in reimbursement. Ensured that operations complied with payer regulations and healthcare industry standards while resolving complex billing disputes with insurance payers.Patient Accounts Billing and Collection Specialist
Wipro Philippines · 2021 — 2022Oversaw patient billing services and collection operations for healthcare accounts, ensuring accurate and timely processing of medical claims and responding to patient inquiries. Managed self-pay accounts, assisting patients with payment arrangements and addressing billing concerns. Maintained high standards of customer service while resolving patient billing issues and worked to improve workflow efficiency in account management.Medical Billing and Collections Specialist (Accounts Receivable)
Optum Global Solutions · 2018 — 2021Handled accounts receivable collections, ensuring follow-up on unpaid insurance claims and the processing of medical billing for various insurance carriers in compliance with payer policies. Reviewed and processed insurance payments while verifying reimbursement accuracy. Investigated denied claims, executing reprocessing and appeals as necessary. Conducted AR follow-up activities to facilitate timely payments and the resolution of outstanding balances.Claims Specialist and Patient Accounts Representative – Blue Shield of California
Teleperformance Cebu · 2016 — 2018Verified patient eligibility while explaining insurance benefits and coverage aspects. Managed the processing of pharmacy claims and resolved associated prescription benefit issues. Oversaw medical claims processing, guaranteeing accurate reimbursement handling and the resolution of billing inquiries while coordinating with insurance carriers regarding any outstanding claims.
Skills & Expertise
Education
- Bachelor of Science in Electrical Engineering (Undergraduate)University of Cebu