Mark L.
Senior Revenue Cycle Management Specialist
Open to offersNew to PlatformAbout
Mark L. D., a distinguished Senior Revenue Cycle & Insurance Specialist based in Rizal, Calabarzon, Philippines, brings over six years of expertise in the U.S. healthcare sector. Specializing in medical billing, claims processing, insurance verification, and AR management, he has excelled in various roles, including his position at Paradigm Senior Services where he managed Revenue Cycle Management (RCM) for home care provider accounts. Mark adeptly utilized systems like Epic and AdvancedMD, ensuring seamless claims processing and denials resolution. During his tenure as a Charge Audit Specialist at Conifer Health Solutions, he safeguarded revenue integrity through comprehensive clinical documentation audits and charge capture processes. Furthermore, his proficiency extends to technical support and customer relations across various industries, exemplified by his contributions to companies like Haulla and Spectrum. Mark holds certifications in HIPAA Compliance, complemented by his educational background with a Bachelor's in Human Resources Development from Trinity University of Asia.
Experience
Account Specialist
Paradigm Senior Services · 2026 — PresentManaged the full Revenue Cycle Management (RCM) for home care provider accounts, facilitating timely reimbursements through claims processing, authorizations, AR monitoring, and denial resolution. Acted as the main client liaison, assisting with onboarding and resolving billing and claims issues while maintaining provider relationships.Charge Audit Specialist
Conifer Health Solutions · 2025 — 2025Conducted thorough reviews of medical records to ensure accurate capture and billing of clinical services, validating coding and billing modifiers. Focused on safeguarding revenue integrity through comprehensive audits of documentation and coding accuracy.Account Manager | Business Development Manager
Haulla · 2024 — 2025Engaged with small business owners across various U.S. cities to introduce company services, establishing contracts and developing a strong sales pipeline. Utilized CRM tools for tracking leads and customer relationships while exceeding sales quotas.Client Services Representative 2
BetterNight · 2023 — 2024Supported sleep therapy services, managed home sleep testing, and handled medical billing while ensuring compliance with HIPAA regulations. Educated patients on equipment use and scheduled appointments while documenting interactions within Brightree CRM and EHR tools.Case Manager | Insurance Verification Specialist
Rula · 2022 — 2023Facilitated patients’ access to behavioral and medical healthcare by managing insurance verification and case coordination processes. Contacted insurance carriers and maintained documentation to support claims processing and resolve coverage issues.Claims Specialist
Breg · 2019 — 2022Processed claims for Durable Medical Equipment (DME) under Workers’ Compensation and Auto Insurance programs. Managed the entire claims lifecycle, from verification through to submission and follow-up, while performing audits for compliance with payer policies.Financial Services Representative
Optus · 2019 — 2019Discussed financial hardship with clients to negotiate payment arrangements. Provided customer assistance, ensuring effective communication and problem-solving while addressing client needs.Mobile Technical Support Tier/2 (Chat)
Optus · 2018 — 2019Delivered technical assistance to customers via phone and chat, addressing mobile device issues and service problems. Demonstrated strong communication and problem-solving skills in customer interactions.Technical Support Representative
Spectrum · 2017 — 2018Handled technical support cases, performing troubleshooting to maintain system functionality. Provided outstanding service and support to clients while efficiently resolving technical issues.Customer Service Representative
Time Warner Cable · 2016 — 2017Assisted customers in understanding their needs, providing resolutions and handling complaints to ensure satisfaction. Engaged in sales support by tracking leads and presenting services to meet customer requirements.
Skills & Expertise
Education
- Bachelor of Business Administration (BBA) in Human Resources DevelopmentTrinity University of Asia · 2012 — 2017