Grandton Almocera

GRANDTON ALMOCERA, PTRP MEDICAL BILLING SPECIALIST | RCM SPECIALIST | A/R SPECIALIST PROFILE CONTACT-- Corner Taal Rd., Matutom St., Davao City www.linkedin.com/in/grandto n-almocera-ptrp- EDUCATION- Bachelor of Science in Physical Therapy ADVENTIST MEDICAL CENTER COLLEGE CERTIFICATIONS 2025 HIPAA CERTIFICATION PREMIER MEDICAL BILLING ACADEMY Compliant with HIPAA Privacy & Security standards for medical billing and patient data handling. SKILLS Revenue Cycle Management Claims Submission & Denial Management Charge Entry Claims Processing Payment Posting (ERA/EOB) EMR/EHR Systems Detail-oriented Medical Billing Specialist with proven expertise in end-to-end Revenue Cycle Management (RCM) for U.S.-based healthcare providers. Skilled in optimizing claim accuracy, reducing denials, and accelerating reimbursement timelines. Experienced in supporting solo practitioners and multi-provider clinics by ensuring timely, clean claim submissions and thorough A/R follow-up, allowing providers to focus on delivering quality patient care. HIPAA certified, with a strong commitment to maintaining patient confidentiality and compliance with federal privacy regulations. WORK EXPERIENCE PRO Network LLC - Lead Medical Biller APR 2020 - JUNE 2025 Key Responsibilities: Accurately enter patient demographics, coding details, and provider information into the billing system Submit clean claims through clearinghouses and ensure compliance with payer-specific guidelines Review and correct clearinghouse/payer rejections, then resubmit claims promptly Investigate denials, determine root causes, file appeals, and submit corrected claims with documentation Contact insurance payers to resolve complex denial or reimbursement issues Post insurance and patient payments (EOBs/ERAs) with precision and handle necessary adjustments Work A/R aging reports and follow up consistently to reduce outstanding balances Amai Pakpak Medical Center - Physical Therapist JAN 2019- JAN 2020 Experience with musculoskeletal, post-operative, neurological, and geriatric cases Strong communicator with interdisciplinary teams including physicians, nurses, and caregivers Emphasize goal-oriented, patient-centered care and progressive functional improvement Committed to building trust with patients and empowering them in their recovery journey CRM/SYSTEMS Tebra/Kareo Simple Practice DrChrono Prompt AdvancedMD PAYER PORTALS & TOOLS Availity Aetna CA CCAH Fidelis Care Nivano Horizon NJ Wellpoint (Amerigroup) Aetna Better Health Nj Anthem Blue Cross