Shiela Marie M.

I am a Medical Billing Specialist and Revenue Cycle Management (RCM) professional with over 4 years of experience supporting healthcare providers and BPO billing operations in high-volume, performance-driven environments. I specialize in optimizing the full revenue cycle process—from patient eligibility and charge entry to claims submission, denial resolution, payment posting, and account reconciliation. My expertise is focused on improving clean claim rates, reducing denials, and accelerating reimbursement cycles through accurate billing workflows and proactive insurance follow-ups. I am highly experienced in ICD-10, CPT, and HCPCS coding, along with managing complex payer requirements, claim corrections, and appeals. I have worked extensively in fast-paced healthcare operations where accuracy, compliance, and turnaround time directly impact revenue performance. I am confident in handling both routine and complex billing scenarios, ensuring that accounts are properly managed and revenue leakage is minimized. Beyond medical billing, I bring strong capability in healthcare administrative support, data integrity management, and CRM/EHR system handling, ensuring that patient and billing records remain accurate, organized, and audit-ready at all times. I also have cross-functional experience in customer service, digital sales support, and e-commerce operations, which strengthened my communication skills, problem-solving ability, and adaptability in handling client-facing and operational responsibilities. 🔑 CORE EXPERTISE Revenue Cycle Management (RCM) Medical Billing & Coding (ICD-10, CPT, HCPCS) Insurance Claims Processing & Submission Denial Management & Appeals Strategy Payment Posting & EOB Reconciliation Eligibility Verification & Charge Entry Patient Account Resolution Healthcare Data Management & CRM Support Administrative & Operational Support 🧰 TOOLS & SYSTEMS MS Excel | Google Workspace | EHR/EMR Systems | Medical Billing Platforms | CRM Systems | Communication Tools (Zoom, Slack, Microsoft Teams) 💼 PROFESSIONAL APPROACH I am detail-driven, process-oriented, and highly reliable in remote environments. I work with a strong focus on accuracy, efficiency, and accountability, ensuring that every task contributes to improved billing performance and operational flow. I am comfortable working independently, managing priorities, and adapting quickly to different billing systems and client requirements.