Ruth E.
Patient Account Specialist
Open to offersNew to PlatformAbout
Ruth E. is an experienced RCM Specialist based in Caloocan City, Philippines, with over eight years of experience in U.S. healthcare operations. Her expertise includes insurance eligibility verification, accounts receivable (AR) follow-up, and U.S. healthcare claims management. At KMC Solutions, she supported client operations for Sightview Software LLC by performing insurance eligibility verification, accurately documenting findings, maintaining patient records, conducting AR follow-ups, and assisting with denial resolution through claim investigation and processing. Previously, at Accenture, she worked as a Provider Appeal Processor and Quality Auditor, handling high-volume insurance claims processing and conducting quality audits to improve accuracy and compliance. Her strong attention to detail, analytical skills, and commitment to quality enable her to deliver reliable results in fast-paced healthcare environments.
Experience
RCM Specialist / Eligibility Verification & AR Follow-Up
KMC Solutions (Client: Sightview Software LLC) · 2025 — 2026Performed insurance eligibility and benefits verification for high-volume patient appointments using payer portals and internal systems. Managed accounts receivable by researching unpaid and denied claims to identify reimbursement issues. Reviewed Explanation of Benefits (EOBs) and claim information to determine appropriate follow-up actions. Contacted insurance companies through payer portals and phone calls to obtain claim status and resolve billing issues. Updated patient insurance information and account documentation to maintain accurate billing records while collaborating with internal teams to support timely reimbursement and meet client quality standards.Provider Appeal Processor / Quality Auditor
Accenture · 2017 — 2025Processed high-volume U.S. healthcare claims while adhering to client guidelines and quality standards. Reviewed provider appeals and supporting documentation to determine appropriate claim resolution. Conducted quality audits to identify processing errors, compliance issues, and opportunities for process improvement. Investigated claim discrepancies, maintained accurate claim records, and ensured HIPAA compliance. Consistently met productivity and quality targets in a fast-paced healthcare environment.
Skills & Expertise
Education
- Bachelor of Science in Business Administration Major in Marketing ManagementUniversity of Caloocan City · 2013 — 2017
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