Sadia B

Operations Manager

Quantum Billing Services • Fulltime

Dec 2019 - Present • 6 yrs 10 mos

Manage daily U.S. healthcare revenue cycle operations, coordinating teams, monitoring performance, resolving operational issues, and improving workflows to support timely billing and collections. - Oversee billing workflows across eligibility verification, charge entry, claim submission, payment posting, accounts receivable, denial management, and patient statements. - Coordinate team workloads, priorities, and follow-ups to keep client deliverables on schedule and address backlogs. - Monitor productivity, quality, aging balances, claim rejections, denials, and timely filing risks; identify issues requiring corrective action. - Guide team members on complex billing problems, payer requirements, and escalations, and follow through on unresolved accounts. - Review workflows to identify delays, repeated errors, and unnecessary manual work; develop clearer procedures and accountability. - Coordinate with clients, management, and internal teams to resolve operational concerns and communicate progress, risks, and next steps. - Review billing vendor usage and costs, including patient statements and paper claims, to identify avoidable expenses and strengthen processing controls. - Support staff training and performance improvement through feedback, workflow guidance, and quality reviews. - Promote accurate documentation and appropriate handling of confidential patient and client information.

Medical Billing Specialist

Upwork • Freelance

Dec 2012 - Present • 13 yrs 10 mos

Provide end-to-end medical billing and revenue cycle support to U.S. healthcare practices, helping clients resolve unpaid claims, address billing errors, and maintain accurate accounts. • Verify insurance eligibility and benefits, coordinate benefits, and follow up on prior authorizations and referrals. • Review and enter charges, submit claims, and resolve clearinghouse and payer rejections. • Post payments, adjustments, and patient responsibility from EOBs and ERAs; investigate underpayments and discrepancies. • Analyze accounts receivable aging reports and follow up on unpaid claims, prioritizing timely filing and appeal deadlines. • Investigate denial reasons and prepare corrected claims, reconsiderations, and appeals with supporting documentation. • Contact insurance companies and patients to resolve outstanding balances and account issues. • Audit accounts for billing accuracy, missing information, and recurring denial patterns. • Prepare patient statements and maintain clear documentation of account actions and follow-up. • Develop billing procedures and recommend workflow improvements to reduce recurring errors and reimbursement delays. • Work across eClinicalWorks, AdvancedMD, DrChrono, Tebra/Kareo, TherapyNotes, Office Ally, and other practice management systems.

Accounts Receivable Specialist

Little Rivers Health Care

Apr 2025 - May 2026 • 1 yr 1 mo

Worked as an Accounts Receivable Specialist for Little Rivers Health Center, managing revenue cycle and AR operations for Federally Qualified Health Center (FQHC) billing services. Handled Medical, Institutional, Behavioral Health, and Dental billing processes while ensuring timely claim resolution, accurate reimbursement, and effective denial management. Responsible for insurance follow-up with commercial payers, Medicare, Medicaid, and managed care plans to resolve denied, rejected, underpaid, and aging claims. Reviewed EOBs, claim status, denial reasons, eligibility issues, authorization requirements, and payment discrepancies to secure accurate reimbursements according to payer guidelines. Performed claim analysis, appeals, corrected claims, reconsiderations, and account resolution while maintaining productivity and quality standards. Worked closely with billing teams, providers, and insurance representatives to identify billing issues, improve claim accuracy, and reduce AR backlog. Experienced in handling both professional and institutional claim workflows, including behavioral health and dental billing. Utilized payer portals, clearinghouses, and billing systems to monitor claim progress, document account activity, and resolve complex reimbursement issues efficiently. Contributed to improving cash flow and operational performance through consistent follow-up strategies, effective communication, and strong understanding of healthcare billing regulations and revenue cycle management processes.