Detail-oriented Medical Billing Specialist with 3 years of experience managing complete Medical billing Revenue Cycle Management. Investigates and resolves insurance claims, Aging Report, Recovery from denied claims, and disputes and communicates with patients and insurances/third parties regarding claims balances resulting major increase in Provider Monthly reimbursement.
Brief intro of me-
I did master in Computer Sciences
My Medical Billing RCM experience includes:
1- Eligibility Benefits
2- Referral Authorization
3- Charge Entry or Billing
4- Rejection Handling at clearing house and Payer level
5- Denial Management/Aging Reports/Charge Reports/Payment Reports
6- Payment Posting
7- Payers and Patients AR collections services.
8- Reporting and analysis
I started my carrier as Medical Biller, AR follow up (Claim Inquiry Specialist). HIPAA privacy rules & compliance awareness. From a Medical billing specialist, AR, EDI Analyst to Management level had almost performed all the tasks related to Medical billing. I am a quick learner, ability to follow instructions and multitask to meet deadlines.
Moreover, I have worked with Different clients and helped Medical billing Companies as Medical biller, AR specialist. 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.
Medical Billing Services includes the following: -
- To check Eligibility and verification of patient’s health benefits from insurance carrier’s website and through Phone.
- Full patient demographics and charge entry
- 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 Plans and Commercial Insurances (Aetna, BCBS, Cigna, UHC, Molina and many more...
- 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
- Daily, Monthly and annual AR Financial reports preparation
- Custom reports where required
- Patient billing as per instructions
- To research the right DX and CPT code according to medical records
- Provide right DX pointers for the first time to avoid payment delays or to avoid from NCD/LCD denials
Billing types I have worked on: - (Professional Billing)
I have complete knowledge of CMS-1500 form that is use for Professional Billing.
- Diagnostic, Pathology, Toxicology Labs.
- Multi-specialist Doctors
Softwares I have worked on: -
- Eclinicalworks (ECW)
- Care Cloud
- Practice mate (Office Ally)
- MicroMD
- Xifin