Ronald R.
Mid-Level Healthcare Claims Specialist
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About
Ronald R. is an experienced Medical Virtual Assistant with a robust background in supporting healthcare professionals in the U.S. He served at Vosa Hand Therapy from February 2022 to July 2024, where he expertly managed patient data entry, claims processing, and invoicing, utilizing systems like ONSATFF and PRIMEMEDICAL. At Phoenix Virtual Solutions, Ronald excelled in payment posting and the rebilling of claims, dealing with insurance entities such as Medicare and Aetna. His tenure at Concord Medical Group as a Revenue Cycle Management Team Lead saw him guiding denial coordinators, executing denial appeals, and generating reports with tools like Tableau and HaloMD. Furthermore, his prior role at Armco Healthcare Partners involved contact with insurers to rectify claim denials. Ronald is proficient in navigating EHR systems, medical billing, insurance verification, and claims processing, complemented by a solid command of tools such as Microsoft Excel and Slack.
Experience
Revenue Cycle Management Team Lead (Denial Coordinator)
Concord Medical Group · 2024 — 2026Created and downloaded reports using Tableau, HaloMD, Radix, and the NSB customer portal, while distributing monthly reports. Supervised Denial Coordinators to ensure adherence to claim processes, provided coaching on a bi-monthly basis, and contributed to monthly company meetings. Produced daily and monthly reports, rectified errors in the claim center, and reprocessed claims using AdvancedMD.Medical Virtual Assistant
Vosa Hand Therapy · 2022 — 2024Entered patient information into the system (ONSATFF, PRIMEMEDICAL) and generated charges for services rendered. Managed claim submissions, both electronically and manually, and followed up with insurance for claims status through calls and online portals. Posted payments and adjusted patient liabilities while creating invoices and appealing denied claims.Payment Poster/ Adjuster, Claim Rebilling
Phoenix Virtual Solutions · 2021 — 2022Posted payments received from various U.S. insurance providers, including Medicare, Aetna, and BCBS, while adjusting payments and patient liabilities. Rebilked denied claims displayed in the database, addressing issues such as incomplete IDs or error codes.Appeal Analyst
Armco Healthcare Partners · 2019 — 2020Verified claim denials by contacting insurance providers and shared patient data with payers to resolve medical-related issues. Submitted appeals or reconsiderations to overturn denials, aiming to recover lost revenue.Transaction Quality Analyst
Concentrix · 2017 — 2019Conducted audits of calls for both tenured and new employees as part of the MIP, delivered Q&A rollouts to new hires, and facilitated mock calls for training purposes. Engaged in quality coaching for markdowns and monitored Post Call Surveys (PCS) as well as FCR reviews.Customer Care Specialist. (Outbound HealthCare Associates)
IBM Daksh PH · 2012 — 2014Called insurance representatives on behalf of healthcare providers to inquire about the status of medical claims. Documented any required information, including medical records and clinical notes, essential for claims processing.
Skills & Expertise
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