Karen M.

I bring over 20 years of experience in medical billing, revenue cycle management, and insurance credentialing. My approach — what I call Proactive Revenue Integrity — addresses denial risk starting at patient registration, not after a claim is denied. I focus on optimizing billing processes, reducing claim rejections, and maximizing reimbursement, with strong expertise in ICD-10 and CPT coding, denial management, and a range of EMR/EHR systems, including Epic, eClinicalWorks, and NextGen. Notable Projects and Accomplishments: Led the EMR and practice management software transition for 46 GI doctors across 9 practices and 6 surgery centers, centralizing the billing process and generating a $600,000 revenue increase within three months For a Pain Management and Anesthesia Group, recovered $120,000 in unpaid claims and increased anesthesia revenue by $90,000 in 6 months Credentialed 200+ providers directly into insurance networks, reducing billing discrepancies and optimizing reimbursement Managed AR follow-ups, billing audits, and denial management for multiple large accounts, consistently meeting monthly revenue targets of $4 million Education and Certifications: Certified Revenue Cycle Representative (CRCR) • Certified Professional Coder (CPC) • Certified Coder (CCS-H, CCS), AHIMA • Extensive training in HIPAA compliance and CMS regulations With a proven track record in improving billing operations, I'm confident in my ability to help your organization streamline processes and drive revenue growth.