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Martin Anzel Macalalad

@martinanzelmacalalad

RCM specialist at OPTUM GLOBAL SOLUTIONS who resolved claim discrepancies and recovered overdue payments.

At OPTUM GLOBAL SOLUTIONS, I reviewed patient accounts, analyzed denials, and contacted insurers to resolve claim discrepancies and secure payments. I also maintained collection records and monitored AR trends.

At MED-METRIX INTERNATIONAL PH-I, INC, I reviewed denied claims, gathered documentation, and drafted appeal letters. I tracked appeal deadlines and analyzed denial trends to identify recurring issues.

Across my medical billing and member services work, I prepared claims, verified eligibility, and followed up on unpaid or denied claims. I have used Epic, Cerner, NextGen, Waystar, MS4, and Invision, while ensuring HIPAA compliance.

Experience

Work history, roles, and key accomplishments

AR Collector Analyst

Optum Global Solutions

Jul 2025 - Oct 2026 (1 year 3 months)

Reviewed patient accounts to identify outstanding balances and overdue claims, analyzed insurance denials, and communicated with insurers to resolve discrepancies. Maintained accurate records and ensured HIPAA compliance during collection activities.

Revenue Cycle Management Claims Processing Denials Management AR Collections HIPAA compliance Epic Cerner NextGen Waystar MS4 InVision

Medical Biller

Care Solutions & Outsourcing

Sep 2024 - Jul 2025 (10 months)

Prepared and submitted medical claims to insurance companies, verified patient coverage, and corrected coding errors. Posted payments, followed up on unpaid claims, and maintained billing records for audits and compliance.

Medical Billing Claims Submission Eligibility Verification Payment Posting Denial Management HIPAA compliance Epic Cerner NextGen Waystar MS4 InVision

Appeal Writer & Denials Management Analyst

Med-Metrix International PH-I, Inc

May 2023 - Sep 2024 (1 year 4 months)

Reviewed denied claims to determine root causes, drafted appeal letters citing medical necessity and coding accuracy, and tracked deadlines. Analyzed denial trends and maintained detailed records of appeals and resolutions.

Appeal Writing Skills Denials Management Claims Processing Root Cause Analysis HIPAA compliance Epic Cerner NextGen Waystar MS4 InVision

Customer Service Representative

Startek

Oct 2021 - Apr 2023 (1 year 6 months)

Provided information on member eligibility, coverage, and benefits, and assisted with billing claims inquiries. Reviewed EOBs, handled authorization requests, and resolved claim issues while maintaining high customer service standards.