Millo Reales

Lead a team of six overseeing daily RCM and AR priorities, account resolution, workflow, and staff accountability. Personally collected approximately $100,000–$150,000 and reduced AR by approximately 12%.

Resolved high-volume insurance denials through EOB review, payer requirements, claim history, and account research. Prepared appeals and corrected claims to recover reimbursable revenue.

Managed an AR portfolio exceeding $2M in monthly revenue and oversaw approximately 22 billers across seven Florida locations. Developed and monitored RCM KPIs and prepared end-of-month reports.

Managed ophthalmology denials involving cataract surgery, glaucoma, duplicate claims, bundled CPT codes, and medical-record requirements. Prepared first- and second-level appeals and corrected claims.

Managed orthopedic referrals and authorizations in Epic while verifying eligibility, payer requirements, and documentation. Ensured referral diagnosis and treatment aligned with services and payer requirements.

Managed insurance authorization workflows, calculating service units, types, and codes requiring approval before care. Targeted authorization submissions approximately 15 days before service and pursued retroactive authorization when needed.

Submitted approximately 30–50 healthcare claims per day across home-care, long-term-care, and assisted-living services. Scrubbed claims and corrected billing/documentation issues using Emdeon.

Built foundational medical billing and collections experience in a rehabilitation setting. Reviewed accounts for insurance-coverage gaps, applied self-pay rates, and consistently exceeded a $5,000–$8,000 monthly self-pay collection target.

Studied Business Administration at Community College of Rhode Island.

Earned a High School Diploma from Ana Roque de Duprey in Puerto Rico.