Mark V.
Senior Medical Billing and Accounts Receivable Specialist
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Mark V., based in Pasig City, Philippines, is a seasoned Medical Billing and Accounts Receivable Specialist with over a decade of experience in the healthcare sector, particularly focusing on the revenue cycle management. He specializes in professional and facility claims, diligently handling accounts receivable follow-up, denial resolution, and insurance verification for various medical institutions. Mark's expertise spans across managing high-volume claims and efficiently reducing outstanding AR balances through robust payer portal navigation and detailed appeals processing. In his role at Horizon Group, he was instrumental in managing billing and payment posting for recuperative care facilities in Los Angeles and San Diego, ensuring compliance with Medicare, Medicaid, and HIPAA standards. His tenure at Sourcefit honed his skills further in revenue cycle functions and precise denial management. Mark's educational background includes a Bachelor of Science in Commerce from Divine Word College of Vigan. He is recognized for his strong analytical skills and meticulous approach to billing accuracy.
Experience
Billing and Accounts Receivable Specialist
Horizon Group (Nautical Staffing) · 2025 — 2026Oversaw the accounts receivable process, billing operations, and payment posting for Recuperative Care facilities in Los Angeles and San Diego. Conducted patient census reviews and clinical documentation audits to maintain billing accuracy and compliance. Handled payment postings and reconciliations while addressing billing discrepancies and following up on unpaid claims. Collaborated with facility personnel and internal teams to troubleshoot billing issues, ensuring adherence to Medicare, Medicaid, and HIPAA regulations.Remote Medical Biller
Sourcefit (AIS Healthcare) · 2021 — 2025Administered medical billing processes and accounts receivable follow-up for Home Infusion Pharmacy and Pain Management accounts. Executed revenue cycle tasks including charge entry, payment posting, adjustments, invoicing, and processing refunds. Addressed insurance follow-up to effectively resolve denied, rejected, and unpaid claims. Utilized payer portals and coordinated with insurance representatives for prompt reimbursement resolutions.Senior Collections Representative (SWAT Team) / Medical Biller
Optum Global Solutions Philippines · 2020 — 2021Managed corrected claims billing for hospital accounts in California. Analyzed denied and underpaid claims to detect reimbursement discrepancies and submitted appeals and reconsideration requests to enhance payment recovery. Conducted insurance follow-up and account resolutions utilizing EPIC and Citrix platforms.Accounts Receivable Collections & Biller Representative
Conifer Health Solutions Philippines · 2018 — 2020Led medical billing and accounts receivable collections for hospital and facility accounts. Investigated denied and underpaid claims and submitted appeals in accordance with CMS guidelines. Carried out insurance follow-up to address aging accounts and enhance reimbursement turnaround using MS4 and Invision/VIWEB systems.Provider / Member Services Representative
Hinduja Global Solutions (Aetna Dental Insurance) · 2016 — 2018Facilitated provider assistance with eligibility verification, claims status inquiries, and benefits clarification. Addressed member issues related to claims, appeals, documentation, and overpayments. Provided accurate account updates while adhering to high customer service standards. Cultivated effective payer communication and problem-solving skills that are applicable to medical billing operations.
Skills & Expertise
Education
- Bachelor of Science in CommerceDivine Word College of Vigan