Summary
Overview
Work History
Education
Skills
Certification
Top Expertise
Timeline
Generic
Richard F. Comia

Richard F. Comia

Brgy. Sabang

Summary

Expert in MEDICAL BILLING bringing 12 years of expertise in US HEALTHCARE industry. Effectively manages assignments and team members. Dedicated to selfdevelopment to provide expectation-exceeding service. Productive employee with proven track record of successful project management and producing quality outcomes through leadership and team motivation. Works with clients to determine requirements and provide excellent service. Innovative Specialist with long history of exceeding client expectations by thoroughly understanding problems and providing creative solutions. Keeps well informed of pertinent legislation and regulations.

Overview

16
16
years of professional experience
1
1
Certification

Work History

Appeals Specialist / RCM / Patient Eligibility Coordinator

Irythm
06.2023 - 12.2024
  • Company Overview: Zio patch
  • Identify the rejection message in Xifin and Niko Health
  • Verifying the denial of the claim
  • Making sure that the claim was billed to the correct payor
  • Verifying if the rejection or claim should be for adjustment, for patient calling or needing assistance from the client
  • Zio patch

Eligibility Coordinator, Appeals Specialist, and Claims Billing

Sunny Days Therapy
05.2023 - 12.2024
  • Company Overview: Behavioral (Speech and Occupational Therapy)
  • Rebilling 2ndry insurance mostly to Medicaid MN via (Waystar)
  • Updating eligibility report
  • Sending Medical reports to insurance via portal (UHC and Availity)
  • Updating patient face sheet or eligibility status via EMR and insurance portal
  • Behavioral (Speech and Occupational Therapy)

Verification Specialist

Sterling Global
03.2023 - 05.2023
  • Verifying applicant's background
  • Calling applicant's universities to check if the applicant was truly graduated to that school
  • Calling previous company to check if they have bad records
  • Update applicant's information
  • Contact applicants for more information, like certifications, reference phone number

RCM / Denial Management

Health Recon connect
08.2022 - 02.2023
  • Reviewing different denials
  • Reviewing patient eligibility via the insurance portal, Advance MD and Trizetto
  • Submitting medical records via portals like (Availity, UHC, etc.)

Insurance Verification and AR Denials Management

Creare Solutions
08.2022 - 08.2022
  • Company Overview: Behavioral for Autism Children (ABA)
  • Insurance Verification
  • Claims follow-up
  • Check claim status via website/portal
  • Posting payment
  • Behavioral for Autism Children (ABA)

Medical Biller / RCM / AR Follow-up Analyst

Alley Health Solutions
03.2022 - 07.2022
  • Company Overview: Rehabilitations and Drugs
  • Submit claims in a professional and timely fashion
  • Investigate and resolve denied claims
  • Submitting Appeals
  • Submit billing data to insurance providers
  • Rehabilitations and Drugs

Virtual Medical Biller / Office Visit

House Call MD
01.2022 - 02.2022
  • Company Overview: Project-based
  • Charge Entry
  • Insurance verification
  • Accounts receivable
  • Project-based

VA Medical Biller / Benefits Eligibility Coordinator

Genesis Healthcare
10.2021 - 12.2021
  • Company Overview: Project-based
  • Verifying patient demographics
  • Verifying patient eligibility thru insurance websites
  • Verifying patient balance if co-pay, ded, or coins
  • Calling insurance for denied claims and for following claims
  • Project-based

Patient Services Representative as Inbound//, Outbound, Transcriptionist, Eligibility Coordinator and Emails

INFINIT-O Inc.
07.2019 - 09.2021
  • Explain the details of the billing statement
  • Sending emails to account receivable team for verification
  • Answers question about the payment policy
  • Explain the patient responsibility (copay, deductible and coinsurance)
  • Call patient to verify if they have received the billing statement

Account Receivable // Claims Specialist // RCM

Gebbs Healthcare Solutions
04.2017 - 01.2019
  • Collect revenue from insurances
  • Resolve claims issue
  • Meet the clients target
  • Verify if the claim was processed correctly

Insurance Verification or Eligibility Coordinator & Account Receivable

Arriva Medical
07.2014 - 06.2016
  • Verify the benefits for Durable Medical Equipment (DME)
  • Verify how the claim was processed
  • Verify the patient's information

Customer Care Specialist

Expert Global Solution
11.2012 - 05.2014
  • Claims Interpreter
  • Verify benefits to the provider
  • Verify claim status to the provider

Secretary of the Headmaster

San Geronimo Emiliani School
06.2011 - 04.2012

Secondary Teacher

St. Vincent De Paul Montessori Science High School
06.2010 - 03.2011

Elementary Teacher

San Geronimo Emiliani School
06.2009 - 03.2010

Education

Bachelor of Science - Elementary Education

San Pedro College of Business Administration

Skills

  • Electronic Health Record System
  • Electronic Medical Records
  • Medical Billing
  • Medical Claims
  • CPT
  • HIPAA
  • Eligibility
  • Accounts Receivable
  • Cash posting
  • Charge Entry
  • Medicare
  • Medicaid
  • Private insurances
  • RCM
  • Referrals
  • Enrollment
  • Prior Authorization
  • Medical Records Review
  • Provider relations
  • Clinical charts
  • Auto claims
  • Worker's Compensation
  • Ophthalmologist
  • Customer Advocate
  • Patient Advocate

Certification

I hereby certify that the above information is true and correct to the best of my knowledge and beliefs.

Top Expertise

  • Medical Billing / Medical Claims
  • Familiarize with CPT and sort of diagnosis code
  • HIPAA Trained
  • Eligibility, Accounts Receivable, Cash posting, Charge Entry
  • Medicare / Medicaid and private insurances.
  • RCM, Referrals, Enrollment, Prior Authorization.
  • Medical Records Review, Provider relations, sort of clinical charts.
  • Auto claims and Worker's Compensation
  • Ophthalmologist (Eye-med) (Eligibility)
  • Customer or Patient Advocate.

Timeline

Appeals Specialist / RCM / Patient Eligibility Coordinator

Irythm
06.2023 - 12.2024

Eligibility Coordinator, Appeals Specialist, and Claims Billing

Sunny Days Therapy
05.2023 - 12.2024

Verification Specialist

Sterling Global
03.2023 - 05.2023

RCM / Denial Management

Health Recon connect
08.2022 - 02.2023

Insurance Verification and AR Denials Management

Creare Solutions
08.2022 - 08.2022

Medical Biller / RCM / AR Follow-up Analyst

Alley Health Solutions
03.2022 - 07.2022

Virtual Medical Biller / Office Visit

House Call MD
01.2022 - 02.2022

VA Medical Biller / Benefits Eligibility Coordinator

Genesis Healthcare
10.2021 - 12.2021

Patient Services Representative as Inbound//, Outbound, Transcriptionist, Eligibility Coordinator and Emails

INFINIT-O Inc.
07.2019 - 09.2021

Account Receivable // Claims Specialist // RCM

Gebbs Healthcare Solutions
04.2017 - 01.2019

Insurance Verification or Eligibility Coordinator & Account Receivable

Arriva Medical
07.2014 - 06.2016

Customer Care Specialist

Expert Global Solution
11.2012 - 05.2014

Secretary of the Headmaster

San Geronimo Emiliani School
06.2011 - 04.2012

Secondary Teacher

St. Vincent De Paul Montessori Science High School
06.2010 - 03.2011

Elementary Teacher

San Geronimo Emiliani School
06.2009 - 03.2010

Bachelor of Science - Elementary Education

San Pedro College of Business Administration
Richard F. Comia