MANZORA AZIMI
Valera Health
Stafford,VA
3
Languages
8
years of professional experience
Results-driven RCM Specialist and healthcare administration professional with over 8 years of experience optimizing medical billing, prior authorizations, and full-cycle accounts receivable. Proven track record of leading high-performing teams, reducing claim denials, executing winning clinical appeals, and ensuring rigorous HIPAA and regulatory compliance across diverse clinical and remote operations.
Work History
RCM Supervisor
2 Years 3 Months- Audited and optimized daily charge capture and reconciliation processes across clinical departments to ensure 100% compliant revenue capture and eliminate revenue leakage.
- Collaborated with leadership and IT to design, audit, and streamline cross-departmental charge workflows and foster organizational compliance.
- Authored and delivered clinical documentation and charge capture training to reduce preventable denials and align teams with updated regulatory and payer guidelines.
- Oversaw end-to-end prior authorization workflows for complex psychiatric and behavioral health treatment plans, ensuring all pre-service medical necessity documentation meets strict commercial and government payer criteria.
- Performed regular audits on authorization tracking logs, identifying patterns in authorization-related denials to implement root-cause fixes across the intake, scheduling, and billing teams.
- Directed, mentored, and scheduled daily operational workflows for a 12-member Revenue Cycle team focused on high-volume AR follow-up, mental/behavioral health billing, and complex aging claim resolution.
- Researched root causes for claim denials by interfacing directly with insurance carriers, provider representatives, and clearinghouse portals to execute complex appeals and overturn rejections.
- Tracked, analyzed and reported key RCM performance metrics (Days in AR, net collection rates, denial trends) to executive leadership to guide strategic decision-making.
- Collaborated with clinical, intake, and credentialing departments to identify billing bottlenecks, streamline front-end data collection, and prevent recurring denial triggers.
- Developed and delivered comprehensive training programs for clinical and administrative staff covering charge capture procedures, medical necessity documentation, and payer guidelines.
Prior Authorization and AR Specialist
1 Year 8 Months- Maintained charge capture accuracy and compliance across multidisciplinary clinical departments by auditing daily workflows and charge reconciliation processes.
- Secured prior authorizations, pre-certifications, and financial clearances across Epic for high-volume outpatient radiology, surgical, and specialty procedure orders.
- Navigated payer web portals (Availity, NaviNet, UHC) and interfaced directly with clinical authorization departments to submit clinical charts, track determination statuses, and expedite urgent pre-service requests.
- Analyzed authorization-based claim denials (e.g., missing auth, expired auth, service code mismatches) to initiate prompt retro-authorizations and formal clinical appeals supported by CPT/ICD-10 medical necessity documentation.
- Managed end-to-end hospital billing, collections, and reimbursement follow-up for unpaid/rejected claims across commercial and government payers.
- Managed peer-to-peer review processes and clinical authorization appeals by coordinating directly with attending providers and payer medical directors to secure coverage approval for denied or retro-authorization requests.
- Drafted Level 1 and Level 2 formal appeal letters supported by clinical documentation to recover revenue on denied surgical, specialty, and mental health claims.
- Applied knowledge of UB-04 field requirements, Revenue Codes, and NUBC standards to maintain compliance with state/federal billing rules.
- Interpreted complex hospital payer contracts and reimbursement methodologies (DRG, Per Diem, Case Rate, Fee Schedule, Stop Loss) to ensure accurate payment reconciliation.
Office Manager
2 Years 11 Months- Oversaw day-to-day clinic operations, prioritized task workflows, and structured team responsibilities to maximize practice productivity.
- Optimized practice revenue by executing precise medical coding and billing processes while managing patient ledger collections and primary/secondary appeal submissions.
- Managed the operational budget, patient ledger billings, payroll processing, and medical inventory.
- Provided continuous training and mentorship to medical staff to enforce administrative standards and HIPAA compliance.
Front Desk Receptionist
1 Year 2 Months- Managed front-office administrative operations including patient scheduling, records management, and check-out payments.
- Managed full-cycle prior authorization submissions for specialized pulmonary diagnostics, outpatient procedures, and branded pharmaceutical prescriptions using CoverMyMeds and electronic prior auth (ePA) portals.
- Verified patient eligibility, benefits, and authorization requirements prior to scheduled appointments to eliminate front-end scheduling bottlenecks and prevent authorization-related claim rejections.
- Accurately recorded and verified patient medical histories within EHR/EMR platforms in strict compliance with PHI privacy rules.
- Assisted with clinical support tasks such as vital signs collection and administering injections.
ER Registrar
2 Years 3 Months- Enforced strict adherence to EMTALA guidelines by securing financial clearance and registration details only after clinical triage and medical screening examinations were initiated.
- Conducted thorough bedside, waiting room, and workstation interviews to capture, verify, and document accurate demographic, guarantor, and emergency contact details for high-volume emergency department patients.
- Executed real-time electronic insurance verification (RTE), correctly identified primary/secondary/tertiary coverage, and coordinated emergency admission notices to prevent front-end claim rejections.
- Calculated and collected upfront patient copays, coinsurance, and deductibles at the point of service using secure payment systems while maintaining supportive, empathetic patient care.
- Administered and archived essential compliance forms, including Medicare Secondary Payer (MSP) questionnaires, General Consent for Treatment, Patient Rights, and HIPAA Notice of Privacy Practices.
- Coordinated closely with clinical triage teams, nursing staff, financial counselors, and case management to accelerate patient intake and facilitate seamless admission workflows.
Education
B.S. - Community Health
- Certified Professional Coder
Skills
Revenue Cycle Management
ICD-10
CPT
& HCPCS
UB04 & Revenue Codes
AR Aging (30/60/90/120+)
Denial & Rejection Trending
Appeals & Medical Necessity
Insurance Verification
Prior Authorizations
HIPAA & PHI Compliance
Team Leadership
Financial Reconciliation
Epic | NextGen
Dr. Chrono | Meditech
LANGUAGES
Turkish (Bilingual)
Farsi (Bilingual)
Uzbek (Bilingual)
Personal Information
Title: REVENUE CYCLE & HEALTHCARE OPERATIONS SPECIALIST
Timeline
RCM Supervisor
Valera Health
04.2024 - 07.2026Read More
Prior Authorization and AR Specialist
INOVA Hospital
04.2022 - 12.2023Read More
Office Manager
Eyad Abu-Hamda, MD, FCCP
01.2021 - 12.2023Read More
Front Desk Receptionist
Eyad Abu-Hamda, MD, FCCP
10.2019 - 12.2020Read More
ER Registrar
Reston Hospital Center
03.2018 - 06.2020Read More
AAPC
from Certified Professional Coder
Read More
George Mason University
B.S. from Community Health
Read More