I have eight years of experience in the medical credentialing and medical billing fields. I have extensive knowledge credentialing groups, providers, and non-physician practitioners in Michigan, Washington, Oregon and Nevada. My medical billing knowledge includes family practice and urgent care billing in Michigan and dermatology in Florida.
I am a current member of the AAPC, earning my certification as a Certified Professional Biller in 2019.
Areas of Expertise
• Credentialing and contracting medical groups, physicians, and non-physician practitioners
• Quarterly demographic attestations
• Tracking and notifying providers of expiring credentials
• Direct source verification
• Fee schedule review and negotiations
• Posting insurance and patient payments – EFT and paper
• Recovery of rejected and unresolved claims
• Collections of past due patient accounts and/or establishing payment plans
• Patient and payer refunds/overpayment notifications
• Submitting primary, secondary and teritiary electronic and paper claims
• Downloading ERA’s / pulling EOB’s from payer sites
• Enrolling in EFT for rapid payer payments
• Preparing reports for patient population data, refunds, & collections activity
• Eligibility and benefit verification
• Coordination of benefits corrections
Payer & Entity Knowledge
• Aetna
• OptumCare Network
• Blue Care Network
• Blue Cross Blue Shield
• Cigna
• Humana
• Humana Military / Tricare
• Medicare and Medicaid, including managed care plans
• Priority Health
• Regence
• Amerigroup
• Premera
• SilverSummit
• PacificSource
• Wellcare
• United Healthcare
• Workman’s Comp
• CAQH
• ProviderSource