Adnan Jafri
@adnanjafri
Revenue cycle AR and credentialing specialist specializing in denials, appeals, and claim edits.
United StatesWhat I'm looking for
I’m an AR Management Specialist (II) with 8+ years in revenue cycle management, specializing in coding, eligibility, AR follow-up, billing, and insurance claims. In my current work at R1 RCM, I investigate and resolve denied, delayed, or underpaid claims using Epic workqueues and claim edit tools, then drive resolution through EOBs, ERAs, and payer correspondence.
I also specialize in facility billing, submitting and resolving UB-04 (CMS-1450) claims, and I submit corrected claims and appeals in line with payer-specific guidelines. Across my roles, I’ve used tools like Change Healthcare and multiple EMR/healthcare systems (including Epic, Athena Health, eClinicalWorks, Cerner, and Allscripts) and achieved a 90% payment recovery ratio on denied and rejected claims.
Experience
Work history, roles, and key accomplishments
Investigated and resolved denied, delayed, or underpaid insurance claims using Epic workqueues and claim edit tools. Followed up on AR across commercial and government payers, tracked claims via Change Healthcare, and submitted corrected claims and appeals for UB-04 (CMS-1450) facility billing while maintaining HIPAA compliance.
Managed daily healthcare billing workflows across multiple EMR systems and completed AR follow-up for denied, unpaid, and underpaid claims, including rejections, claim edits, and secondary billing. Verified eligibility and benefits, analyzed coding issues (modifiers, ICD-10, CPT, HCPCS), created and submitted appeals, and achieved a 90% payment recovery ratio for denied and rejected claims.
Patient Acc Rep
Exponere Billing
Jan 2019 - Jan 2021 (2 years)
Handled AR follow-up for rejections, denials, collections, EOB processing, claim edits, and eligibility & benefits verification for government, commercial, and workers’ compensation payers. Coordinated benefits with patients (COB/demographic updates) and created and submitted appeals for denied and rejected claims.
Credentialing Specialist
Physicians Revenue Group
Jan 2017 - Jan 2019 (2 years)
Prepared provider credentialing and re-credentialing files for commercial (e.g., BCBS, Aetna, UnitedHealthcare, Cigna, Humana), Medicare, Medicaid, and workers’ compensation panels, including ongoing follow-ups and supporting documentation submission. Maintained CAQH, NPI, licenses/DEA/malpractice and certification records, set up EFT enrollments, and trained new employees on medical information a
Education
Degrees, certifications, and relevant coursework
Old Dominion University
Master of Science in Computer Engineering, Computer Engineering
Earned an MSc in Computer Engineering from Old Dominion University in Virginia.
Availability
Location
United StatesAuthorized to work in
Job categories
Skills
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