Over the last 6 years, I am working with a USA medical billing company as a Medical Billing Specialist. To work as a Medical Biller and A/R Specialist and Team lead.
From a Medical billing Executive, AR, EDI Analyst to Team leader or supervisor level had almost performed all the tasks related to Medical billing. As a team leader I lead the group of 58 employees and look after all of their administrative and operational tasks.
As a team leader, I have worked on Company top priority projects. I have also made company's Business and strategic plans and also worked on highest priority projects and acquisitions assigned by company Managers and Directors. I was the part of company's top managements so in that way mostly involved in making marketing strategies and guiding marketing executives in their projects. Financial analysis also been done for different projects. I have also experience to communicate with US doctors and other third party healthcare staff i.e. insurances, doctors, clearing houses and other third party payers. I have also visited US and visited doctors’ offices and hospitals to completely know about their processes.
- Solid knowledge of HIPAA, medical billing concepts and medical terminology.
- Proficient assignment of appropriate ICD-9 &10 and CPT codes.
- Strong understanding of claims, EOB's and denials.
- Extensive knowledge of both government and private insurance policies.
- Thorough follow up mechanism with insurance companies, healthcare providers, and
patients
- Timely management of unpaid claims as assigned.
- Effective handling of complex claim denials.
- Smart analysis of statistical data and generation of aging reports.
I have worked on the following Specialties:
- Cardiology
- Chiropractic
- Dermatology
- Emergency Medicine
- Family Practice
- General surgery
- Gynaecology and obstetrics
- Internal Medicine
- Orthopaedic
- Pathology
- Pediatrics
- Physical Medicine and Rehabilitation
- Physical Therapist
- Psychiatry
- Neurology
- Radiology
- Radiotherapy
- Rheumatology.
a) Medical Billing Services include the following;
- Checking eligibility and verification of patient benefits with his/her insu
Work Terms
Working As seniorTeam Lead January 2013 to Till date
1.Daily meating with clients regarding issues.
2.Daily meating with billing excustives regarding billing and coding issues.
3.Reviewing medical procedures as documented by doctors.
4.Translating medical procedures into codes that can be translated by payers, other medical coders, and other medical facilities.
5.Transmitting coded patient treatment information to payers and other recipients.
6.Coordinating insurance reimbursement of care providers.
7.Handling patient billing.
8.Reviewing patient medical records.
9.Coding treatment information using Common Procedure Terminology (CPT) codes.
10.Communicating with medical billing specialists to ensure treatment codes are accurately received.
11.Responsible for the accurate flow of medical information and patient data between physicians, patients and third-party.
12.Investigate the claim, verify its information, and update the database.
13.Billing interact with insurance companies and with patients to ensure accurate, streamlined billing and paymentd.
14.Responsible for the timely submission of technical or professional medical claims to insurance companies including physician offices, hospitals, nursing homes, or other health care facility.
15.Receiving patient treatment codes to use in assembling reimbursement claims.
16.Creating reimbursement claims and transfer to third-party payers.
17.Coordinating reimbursement activities with payers.
18.Billing patients for medical services.
19.Era payments and denials.
20.Eob payments and denials.
21.followup on unpaid sclaims and live calls to insurance companies.
22.All accounts are to be reviewed for insurance or patient follow-up.
23. Reviewing patient bills for accuracy and completeness and obtain any missing information.
24. Knowledge of insurance guidelines especially Medicare and state Medicaid.
25.Follow up on unpaid claims within standard billing cycle time frame.