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Revenue Cycle Team Lead
Revenue Cycle Team Lead at JAG Physical Therapy who collected approximately $100K–$150K and reduced AR by 12%.
United StatesRevenue Cycle Team Lead at JAG Physical Therapy
Lead a team of six overseeing daily RCM and AR priorities, account resolution, workflow, and staff accountability. Personally collected approximately $100,000–$150,000 and reduced AR by approximately 12%.
Revenue Cycle ManagementAccounts ReceivablePayer EngagementCollectionsWorkflow ImprovementTeam Leadership
Resolved high-volume insurance denials through EOB review, payer requirements, claim history, and account research. Prepared appeals and corrected claims to recover reimbursable revenue.
Denial ManagementEOB AnalysisAppealsClaim RemediPayer Requirements
Studied Business Administration at Community College of Rhode Island.
Earned a High School Diploma from Ana Roque de Duprey in Puerto Rico.
Managed an AR portfolio exceeding $2M in monthly revenue and oversaw approximately 22 billers across seven Florida locations. Developed and monitored RCM KPIs and prepared end-of-month reports.
Revenue Cycle ManagementAccounts ReceivableKPI developmentTeam LeadershipPayer ManagementReporting
Managed ophthalmology denials involving cataract surgery, glaucoma, duplicate claims, bundled CPT codes, and medical-record requirements. Prepared first- and second-level appeals and corrected claims.
Denial ManagementAppealsCPT ICD10 CodesUB 04Claims Correction
Managed orthopedic referrals and authorizations in Epic while verifying eligibility, payer requirements, and documentation. Ensured referral diagnosis and treatment aligned with services and payer requirements.
EpicReferral ManagementAuthorizationEligibility VerificationPayer Requirements
Managed insurance authorization workflows, calculating service units, types, and codes requiring approval before care. Targeted authorization submissions approximately 15 days before service and pursued retroactive authorization when needed.
Insurance AuthorizationWorkflow ManagementPayer EngagementReimbursement
Submitted approximately 30–50 healthcare claims per day across home-care, long-term-care, and assisted-living services. Scrubbed claims and corrected billing/documentation issues using Emdeon.
Medical BillingClaims SubmissionEmdeonPayer RequirementsBlue Cross Blue ShieldAetnaFlorida Medicaid (AHCA)
Built foundational medical billing and collections experience in a rehabilitation setting. Reviewed accounts for insurance-coverage gaps, applied self-pay rates, and consistently exceeded a $5,000–$8,000 monthly self-pay collection target.
Medical BillingCollectionsCMS 1500UB 04Payer RequirementsMedicaidCommercial Insurance
Profile sourced from Himalayas.