paul C.
Senior Medical Billing Specialist
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Paul Christian V. is a dedicated Medical Billing Specialist and Team Lead with over eight years of expertise in healthcare revenue cycle management. He has a proven track record of excellence in insurance claims processing, accounts receivable follow-up, denial management, charge entry, medical coding, and quality assurance. With extensive knowledge of Medicare, Medicaid, HMO, and commercial insurance billing, Paul has consistently improved claim accuracy and reduced denials, thereby maximizing reimbursement through optimized revenue cycle processes. Notably, at New Horizon, he excelled in AR Follow-Up, handling claim status, denials, and payment processing with precision. His leadership skills were further honed at Rocky Mountain Laboratories, where he led a team to adhere to strict billing policies, performed quality audits, and facilitated communication to enhance efficiency and compliance. Proficient in CPT, ICD-10, and HCPCS Coding, Paul also brings substantial experience in guiding and coaching billing staff, process improvements, and claims auditing.
Experience
Medical Billing Specialist – AR Follow-Up
New Horizon · 2025 — 2026Followed up with insurance companies regarding claim status and payment processing. Investigated denied or delayed claims to ensure timely reimbursement. Maintained records of claim status using Smartsheet, while tracking claim numbers, payment dates, and reimbursement amounts for multiple providers. Collaborated with insurance representatives to resolve billing discrepancies.Medical Billing Team Lead
Rocky Mountain Laboratories · 2024 — 2025Led a team of medical billers to ensure compliance with billing policies. Performed quality audits to enhance claim accuracy and reduce denials. Worked together with Denial Management and Back Office teams to pinpoint trends and enact corrective measures. Provided coaching and training to billing staff and facilitated daily meetings with onshore billing management to discuss workflow and process improvements.Medical Biller
Rocky Mountain Laboratories · 2023 — 2024Processed laboratory billing for various tests including Chemistry and Women's Health. Conducted charge entry and utilized ICD-10 coding. Verified insurance eligibility through payer portals and submitted claims to both primary and secondary insurance carriers. Updated patient demographic and insurance information to ensure accuracy in claims.Medical Biller
Sourcefit · 2022 — 2023Managed ophthalmology billing processes, ensuring accurate claim submissions after closing charges. Utilized insurance portals to verify claim status and resolve related billing issues while performing charge entry and ICD-10 coding.Medical Biller / Subject Matter Expert (SME)
Ruby Staffing Inc. · 2021 — 2022Created insurance claims from provider superbills while performing CPT and ICD-10 data entry. Processed charge entry and handled billing for primary to secondary payers, along with updating patient demographics. As a Subject Matter Expert, provided guidance and process updates to team members, conducted coaching sessions, and performed audits to ensure claim accuracy and compliance prior to submission.Medical Data Entry Specialist
FBC Asia Pacific · 2020 — 2021Updated patient demographic information and processed COVID-19 insurance billing documentation. Maintained accurate healthcare and billing records while handling charge entry and ICD-10 coding. Verified insurance eligibility through payer portals.Support Service Administrator
Alorica – Getix Health · 2017 — 2020Processed healthcare claims using UB-04 and CMS-1500 forms, resolving denied claims and verifying patient insurance eligibility and benefits. Coordinated billing activities between primary and secondary insurance carriers while also updating patient demographic and insurance records.
Skills & Expertise
Education
- Tertiary EducationDr. Carlos S. Lanting College · 2012 — 2013
- Secondary EducationHoly Child Academy, Quezon City · 2008 — 2010
- Primary EducationPlacido Del Mundo Elementary School · 2001 — 2006