Clifford G.
Mid-Level Medical Billing Specialist
Open to offersNew to PlatformAbout
Clifford G. is a seasoned medical billing specialist with a robust background in both professional and hospital billing, densely experienced in the healthcare industry. His expertise is evident in his work handling complex EHR/EMR systems such as Epic, HelloNote, and Simple Practice, ensuring compliance with healthcare regulations. Working as an Account and Office Manager at Well-Nurtured Development Therapy Clinic, Clifford expertly managed financial operations, from patient billing to coordination with insurance companies, ensuring smooth financial processes and compliance. His proficiency includes obtaining prior authorizations, verifying insurance coverage, and maintaining compliance with payer requirements. As a Subject Matter Expert at Med-Metrix Manila, he oversaw healthcare claims to guarantee payment precision and adherence to industry standards, significantly contributing to the effective revenue cycle management. Clifford holds a Bachelor of Science in Business Administration majoring in Marketing Management, leveraging this education to optimize billing operations and enhance service delivery to providers and patients.
Experience
Account and Office Manager (Medical Biller, Prior Auth and Eligibility & Benefits)
Well-Nurtured Development Therapy Clinic · 2025 — 2026Oversaw the clinic's financial operations by handling patient billing and interfacing with insurance companies. Worked on ensuring financial viability and compliance with regulations. Managed prior authorizations for services and medications, verified patient insurance coverage, and communicated with insurance providers for timely approval.Account Manager (Medical Biller/ Medical Claims Analyst)
DeveloPeds Therapy Clinic · 2024 — 2025Responsible for the smooth operation of the financial processes, from patient billing to insurance interactions. Ensured ongoing financial viability and compliance with existing regulations.Account Manager (Medical Biller / Medical Claims Analyst)
GreenThumb Revenue Cycle · 2024 — 2025Managed and processed insurance claims for healthcare services. Analyzed Explanation of Benefits (EOBs) and remittance advice to ensure accurate payment posting. Engaged in follow-up communications with insurance companies regarding unpaid claims, addressed billing issues, and managed claim denials through timely appeals.Medical Biller (Subject Matter Expert)
Med-Metrix Manila · 2023 — 2024Reviewed and processed healthcare claims to confirm accurate payments while adhering to relevant policies. Managed the revenue cycle effectively to minimize payment delays and comply with industry standards.Medical Biller (Hospital Billing)
NTT Data Services PH · 2021 — 2023Ensured timely reimbursement for hospital services by managing the billing process and communicating with insurance companies and patients. Followed the revenue cycle management (RCM) process and handled appeals for technical and clinical denials.
Skills & Expertise
Education
- Bachelor of Science in Business administration major in Marketing managementInternational Peace Leadership College · 2016 — 2021
Interested in this professional?
Sign in as an employer to save this profile or invite Clifford G. to a job.
Sign in as an employer