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I help healthcare organizations reduce compliance risk, improve audit readiness, and streamline operations through structured HIPAA documentation, workflow design, and policy development. As a Healthcare Operations & Compliance Consultant, I specialize in translating complex regulatory and clinical requirements into clear, usable systems that teams can implement quickly and consistently. I’ve supported healthcare environments including specialty care and sleep medicine, with hands-on experience in documentation workflows, patient data handling, and compliance alignment. My work includes: • Policy and procedure development • Process documentation and workflow standardization • Clinical documentation review • Audit readiness support • Governance and board-ready materials • EHR workflow documentation With hands-on experience in healthcare operations and documentation oversight, I bring a systems-focused, evidence-based approach to every engagement. I identify gaps, standardize terminology, and organize complex information into usable frameworks that teams can implement and sustain. I deliver professional documentation and operational systems that support leadership, compliance, and measurable efficiency. Core Strengths • Healthcare operations & compliance • Audit readiness & documentation review • Policy alignment & process standardization • EHR workflow documentation • Governance materials & reporting • Structuring complex healthcare systems What You Can Expect Audit-ready documentation aligned with real clinical workflows Clear, structured policies your staff can actually follow Reduced compliance risk through standardized processes Fast turnaround with minimal oversight required Special Focus Areas: IntakeQ / PracticeQ setup & workflow optimization Clinical intake, documentation, and patient flow design Compliance workflow alignment (HIPAA, audit readiness) Identifying system gaps between intake, billing, and documentation SOPs that match real-world operations (not just policy requirements) I bring experience from healthcare operations roles including the VA and private practice settings.

I am a bilingual remote professional specializing in operations and project management. With an extensive background in telehealth, clinical coordination, and executive support, I bridge communication gaps and streamline complex workflows. I thrive in remote-first environments, delivering precision-led solutions that drive organizational efficiency and project success. I operate with native-level Spanish fluency and C1 advanced English , seamlessly supporting U.S. clinical teams across day, evening, night, or weekend shifts. I have a proven track record of handling front-end clinical operations, medical administration, and bilingual triage for high-volume networks based in California, Florida, and New York. 🔹 Core Healthcare Expertise & Platform MasteryEHR & Digital Health Platforms: Advanced hands-on mastery of IntakeQ (intake workflows, multi-provider calendar coordination, psychiatric templates) and CharmEHR (front-end scheduling, medical agendas, and digital reception). Highly adaptable to platforms like Zoom Health and proprietary telehealth ecosystems. 🔹AI-Driven Efficiency: Expert at leveraging advanced AI tools (including ChatGPT) to streamline complex medical literature reviews, extract key clinical data points, synthesize international chronic disease guidelines, and optimize administrative copy. 🔹Bilingual Medical Interpretation: Providing consecutive and simultaneous interpretation (English/Spanish) during telehealth sessions, live consultations, pre-surgical assessments, and virtual aesthetic evaluations. 🔹Pharmacy & Insurance Coordination: Direct experience routing and verifying prescriptions with major U.S. pharmacy chains (CVS, Walgreens, Walmart) and checking insurance eligibility with regional networks like Ambetter and Sunshine Health. 🔹Clinical Communication Operations: Managing high-volume inbound/outbound calls, medical virtual triage, voicemail management, patient navigation, and professional email correspondence. 🔹 Highlighted Remote Experience Renewed Mental Health Group (California): Telehealth Care Assistant. Managed secure patient intakes and multi-provider psychiatry calendars using IntakeQ, enforcing strict HIPAA compliance. Sarasota Healthcare 168 (Florida): Telehealth Receptionist. Directed virtual front-end operations, patient scheduling, insurance verification, and care coordination through CharmEHR. New Jersey Janeda Orthopedics & Lov MedSpa (New York): Remote Medical Interpreter. Facilitated live virtual consultations, medical-aesthetic discovery calls, and multi-location appointment routing. Calcium Digital Health & LV8 Health (Illinois): Telehealth Assistant & Research Writer. Utilized AI tools to synthesize medical research and supported operations in elite precision longevity/anti-aging medical clinics. 🔹 Clinical Competence (MD Background) My background as a practicing physician gives me a distinct advantage over standard virtual assistants. I possess deep intuitive knowledge of medical terminology, protocol compliance, and multi-disciplinary care across: Internal Medicine, Pediatrics, OB/GYN, Surgery, and Psychiatry. Longevity Medicine (Medicine 3.0), Anti-Aging, and Medical Aesthetics. Chronic Care Management (Diabetes, Hypertension) and Mental Health. 🔹 Elite Remote Setup & 100% Uptime I maintain a professional, secure home office infrastructure ensuring zero communication gaps and total clinical confidentiality (HIPAA-aligned): Hardware: Intel i7 Processor, 32 GB RAM, 2 TB Storage. Peripherals: Noise-canceling headset, dedicated workspace. Connectivity: High-speed fiber internet with a completely independent MiFi backup system for uninterrupted connection. Whether your organization requires complex multi-provider shift coordination, meticulous billing/insurance intake, or precise cross-cultural medical translation, I deliver clinical accuracy and results. Let’s connect to discuss how I can elevate and streamline your remote healthcare operations!

I help healthcare organizations navigate complex licensing, compliance, and operational challenges with tailored, results-driven solutions. As the Principal Consultant of CHCS Group, I bring over a decade of experience in regulatory compliance, SOP and policy development, and healthcare operations. With 75+ successful projects completed for providers across the U.S. including many on Upwork, I’ve supported startups and established organizations through licensure, operational launch and accreditation readiness. I hold an MBA in Complex Health Systems, which informs my strategic approach to healthcare operations, compliance frameworks, and systems improvement. What I Offer: • Healthcare Facility Licensing • Custom Policy, Procedure and SOP Manuals • Joint Commission and CARF Accreditation Survey Readiness • Business Plans, Market Research & Public Need Reports • Interim and Fractional Leadership Solutions • Workflow Optimization Why Clients Choose Me: • Top Rated with a 100% Job Success Score • Healthcare compliance subject matter expert • 75+ successful projects nationwide • Custom deliverables aligned with regulatory standards • Proven results with Joint Commission and CARF readiness Let’s Work Together Whether you're launching a new facility or preparing for your next survey, I’ll help you simplify compliance and move forward with confidence. Let’s connect!

Healthcare virtual assistant with 9+ years of experience across insurance appeals, claims processing, patient coordination, and Medicare operations. I've worked with major healthcare organizations including Optum, Cognizant/Molina Healthcare, and multiple remote medical practices, consistently delivering accurate, compliant, and patient-centered support. What I bring to your team: - Insurance verification, prior authorization, and appeals/grievance processing (Molina Healthcare, Optum) - CRM management, lead follow-up via text/email, and Google Sheets reporting for Medicare clients - End-to-end patient referral coordination, specialist scheduling, and EHR documentation - Compliance-focused work aligned with CMS, ACA, and health plan regulatory standards - Clear, professional written communication, zero errors, high attention to detail - I've logged 1,800+ hours on Upwork across healthcare contracts and consistently deliver on time without handholding. I'm reliable, tech-savvy, and thrive in remote, fast-paced environments. If you need someone who understands the healthcare back-office inside and out, from Medicare leads to complex appeals, I'm ready to jump in.

I am a HIPAA-Certified Medical Biller, Medical Virtual Assistant, and Revenue Cycle Management (RCM) Consultant with 15+ years of professional experience supporting U.S. healthcare providers. I specialize in Mental Health, Psychiatry, and Behavioral Health billing, helping practices streamline their revenue cycle, reduce claim denials, and improve cash flow. Throughout my career, I have supported private practices, group practices, hospitals, laboratories, and telehealth providers, managing the complete medical billing lifecycle from patient registration to final reimbursement. I have also worked as a Senior Operations Manager, leading teams of 200+ medical billing professionals, overseeing operational workflows, quality control, and revenue performance. I hold CPB (Certified Professional Biller) and CPC (Certified Professional Coder) certifications and have completed Medicare educational programs related to HIPAA EDI Standards and Medicare Fraud & Abuse compliance. My goal is to help healthcare providers focus on patient care while I handle the complexity of billing, compliance, and revenue optimization. Medical Billing Specialties I have extensive experience providing billing services with a strong focus on Mental Health, Psychiatry, and Behavioral Health practices, including individual therapists, group practices, psychiatrists, psychologists, and telehealth providers. • Mental Health / Behavioral Health Billing • Psychiatry & Psychology Billing • Therapy Practice Billing (Individual, Group, Family Therapy) • Telehealth & Telepsychiatry Billing • Outpatient & Inpatient Practices • Independent Laboratories • Home Health & DME Billing • Telemedicine Services This includes billing for services such as psychiatric evaluations, medication management, individual therapy, group therapy, behavioral health assessments, and ongoing treatment services, while ensuring HIPAA compliance and payer guideline adherence. Specialties Supported Sleep Medicine • Internal Medicine • Family Practice • Radiology • Cardiology • Ophthalmology • Dermatology • Gynecology • Urology • Rheumatology • Physical Therapy • Neurology • Pain Management • Psychiatry • Pediatrics • Podiatry • Psychology • Gastroenterology • Urgent Care • Mental & Behavioral Health • Pathology • Phlebotomy • CPAP & BiPAP Billing • Nurse Practitioners (NP / ANP) • Physical Therapy (PT) • Occupational Therapy (OT) • Speech Therapy (ST) • COVID Billing Insurance & Payer Experience Extensive experience working with major U.S. insurance payers including: Medicare • Medicaid • BCBS • UnitedHealthcare • Aetna • Cigna • Humana • Workers’ Compensation and multiple commercial insurance plans. I have handled billing operations for providers across many U.S. states including: Alaska • Arizona • Colorado • Connecticut • Idaho • Iowa • Maryland • Massachusetts • Minnesota • Montana • New Mexico • Vermont • Washington • Alabama • Illinois • Indiana • Kentucky • New Jersey • New York • Ohio • California • Florida • Georgia • Michigan • Missouri • North Carolina • Oklahoma Core Skills • End-to-End Revenue Cycle Management (RCM) • Insurance Verification & Eligibility Checks • Medical Coding (ICD-10, CPT, HCPCS) • Claim Creation & Submission (CMS-1500 / UB-04) • Denial & Rejection Management • Accounts Receivable (AR) Follow-ups • Insurance Calls & Claim Resolution • Payment Posting (ERA / EOB) • Medical Documentation Review • Provider Credentialing & Insurance Enrollment • HIPAA Compliance & Billing Audits • Financial Reconciliation (Daily / Weekly / Monthly / Quarterly) I perform efficiently in complex healthcare environments with minimal supervision, ensuring accuracy, compliance, and timely reimbursements. EHR / Billing Software Experience SimplePractice • AdvancedMD • Kareo • OfficeAlly • Docutap • Athenahealth • Therabill • eClinicalWorks (ECW) • EZClaim • TheraNest • ClinixPM • eThomas • Intergy • TherapyNotes • Waiting Room Solutions • Zendesk • Xifin • Phicure • TriZetto • CareCloud • Brightree • CollaborateMD • iPatientCare • Medisoft • Healthnautica Services I Provide I offer complete Revenue Cycle Management services, including: • Provider Credentialing & Insurance Enrollment • Medical Coding & Charge Entry • Claim Scrubbing & Submission • Rejection & Denial Management • Appeals & Insurance Follow-ups • Accounts Receivable (AR) Management • Payment Posting & Financial Reconciliation • Patient Billing Support & Calls • Appointment Scheduling & Medical Virtual Assistance I work closely with healthcare providers to develop customized billing workflows tailored to their practice, ensuring faster reimbursements, reduced denial rates, and optimized revenue performance.

I am a dedicated and results-driven healthcare Revenue Cycle Management (RCM) professional with extensive experience spanning the entire revenue cycle, from front-end patient services to back-end collections and analytics. With a solid foundation in both administrative and operational healthcare processes, I bring a comprehensive understanding of the financial and regulatory challenges healthcare providers encounter across multiple specialties. Over the years, I have successfully supported solo providers, group practices, specialty clinics, and multi-location organizations by streamlining their RCM workflows, reducing denials, and enhancing financial performance. Currently, I supervise a team of 35+ skilled RCM professionals and support 25+ providers, ensuring quality delivery, compliance, and performance excellence across multiple clients and specialties. My leadership focuses on continuous improvement, training, and optimization of billing operations. My hands-on experience with diverse EHR and practice management systems, clearinghouses, and payer portals makes me a versatile and highly effective team member and billing strategist. Areas of Expertise: 1- Front-End Revenue Cycle Support: * Appointment Scheduling * Eligibility & Benefits * Pre-Authorization and Referrals * Patient Communication & Reminders * Medical Record Management * Pre-Appointment Chart Updates 2- Back-End Revenue Cycle Management: * Claims Scrubbing & Submission * Denial Management * A/R Management * Patient Statements & Billing * Payment Posting * EDI & ERA Enrollment 3- Provider Credentialing and Enrollments: * Payer Enrollment & Contracting * Re-Credentialing Management * CAQH Profile Setup & Maintenance * Status Updates & Reporting * Contract Review & Negotiation Support * EFT Enrollment 4- RCM Auditing and Revenue Analysis: * Revenue Cycle KPI's Evaluation * Underpayment Recovery Audit * Revenue Loss Detection * Financial Performance Assessment * Root Cause Analysis of Denial Trends * RCM Metrics Tracking 5- Specialties I’ve Worked With: * Internal Medicine * Multispecialty Clinics * Emergency Centers * Neurology * Dermatology * Gynecology * Podiatry * Pain Management * Pediatrics 6- Software and EHR/EMR Platforms: * eClinicalWorks (ECW) * Athenahealth * CollaborateMD * Kareo / Tebra * EZClaim * AdvancedMD * Veracity * CharmHealth * Practice Fusion * EPIC * Office Ally 7- Clearinghouse Platforms: * Trizetto (Cognizant) * Availity * Waystar * Claim.MD 8- Technical Skills: * Proficient in Microsoft Office Suite, including Outlook, Excel, Word, and PowerPoint * Experienced with Google Workspace tools such as Sheets, Docs, Drive, and Calendar * Skilled in navigating multi-payer access platforms (e.g., Availity, UHC, IEHP, and others) * Expertise in data entry, batch processing, and report generation for RCM workflows * Strong capabilities in advanced reporting and data-driven performance analysis Why Work With Me? I bring more than just technical know-how. I offer a proactive, problem-solving mindset with a focus on accuracy, efficiency, and patient satisfaction. Whether you're seeking someone to handle claim workflows, reduce denial rates, assist in credentialing, or audit your financial processes for hidden revenue gaps, I can deliver measurable results. My approach is always centered on: * Communication: I maintain open, timely, and professional communication with providers, patients, and insurance representatives * Accountability: I take ownership of my work and strive to meet deadlines without compromising on quality * Adaptability: I am quick to learn new systems, adapt to new payer rules, and scale workflows based on your practice’s growth If you're looking for a seasoned healthcare billing expert who combines attention to detail with team leadership and operational insight, I’d love to connect and explore how I can support your practice.