Jerry J. - Medical Billing Back Office Specialist

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Medical Billing Back Office Specialist

Medical billing specialist with over 3 years handling U.S. healthcare claims from submission through payment, plus 4 years in insurance-adjacent customer and account support, including administrative and accounts receivable follow-up. Day-to-day work includes verifying ICD-10 and CPT coding, working denials, writing appeals, and reading EOBs and ERAs to post payments. Checks whether a provider is in-network or out-of-network during benefit verification, since that status changes how the claim gets billed to the patient. Prior BPO experience includes fielding treatment authorization inquiries and explaining to members and providers why a procedure was denied for missing prior authorization, and what was needed to resolve it. Comfortable talking directly to commercial insurance carriers to resolve claim status and payment issues. Trained in HIPAA compliance and used to keeping accurate, audit-ready billing records and patient invoices under deadline pressure. Have not yet supported a formal arbitration submission, but works both in-network and out-of-network claims as part of everyday billing.

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Hire Jerry for: VA for Medical Practices, VA for Telehealth