Hello, I am new to GURU and I look forward to working as a Medical Billing / Project Manager or in another Healthcare position which, fully utilizes my skills and experience while offering an opportunity for advancement.
I have worked 6 years in a US-based company. From a Medical billing specialist, Claim Specialist, Pre-Authorization Specialist to Management level. I had almost performed all the tasks related to Medical billing. As Operations Manager, I lead the group of 8 employees and look after all of their administrative and operational tasks.

As a Medical billing specialist and Operations Managers I have worked on Company top priority projects. I have worked on highest priority projects and acquisitions assigned by company CEO and GM. I have also experience to communicate with US doctors and other third party healthcare staff i.e. insurances, doctors, nurses and other third party payers.

A) Medical Billing Services includes the following:-
- Checking Eligibility and verification of patient’s health benefits from insurance carrier’s website and through Phone and Portal.
- Insurance claims submission (primary, secondary or tertiary)
- Accounts receivable analysis with corrective and preventive actions and decision making for Collections
- Strong claims follow up on denials from insurances like Workers Comp, Medicare, Medicaid, BCBS Semi Government, Managed care and Commercial Insurances (Aetna, BCBS, Cigna, UHC, Oxford etc...)
- Patient billing inquiries as per received information from provider office
- To check claim status from insurance, websites, auto response unit and via live calls.
- To make on call appeals for reprocessing of incorrectly processed claims based on billing knowledge
- ICD10, CPT and HCPCS Coding and/or review, Encoder pro Expert licensed version guided for correct coding
- Appeals

(B). Medical Coding
- To research the right DX and CPT code according to medical records
- Provide right DX pointers for the first time to avoid payment del