I am a HIPPA Certified Specialist in the US healthcare Industry. For over Seven years, I have worked in developing and implementing RCM solutions for healthcare practitioners. This includes extensive work in credentialing services Healthcare practice reporting, Medical Billing, EDI and ERA setup, and In-network and out-of-network benefits and verifications. and other Insurance processing and denial management services.
I am adept at reviewing denials details provided by payers, identifying the reasons behind denials, and taking prompt corrective actions.
I have a proven track record of resubmitting claims after addressing coding errors, updating missing information, and providing additional documentation where necessary. Additionally, I am well-versed in navigating payer appeal processes and have achieved positive outcomes in overturning unjustified denials. To support my expertise, I continuously stay updated on industry best practices, coding guidelines, and payer policies related to denials management.
I possess advanced expertise in effectively utilizing diverse billing software and proficiently navigating its features and functionalities. Moreover, I excel in the intricate process of establishing a new practice within any billing software, underscoring my versatility and competence in medical billing operations.