Medical Billing|Coding and AR Expert

To work as a self-employed Medical Biller or in another Healthcare position that fully utilizes my skills and experience while offering an opportunity for advancement. I am working in a US-based company from last 5 years. From a Medical billing executive, AR specialist to Management level has almost performed all the tasks related to Medical billing. As an RCM specialist, I have done various audits for medical practices and highlighted issues, and gave suggestions, how to improve the revenue of practice and minimize billing errors. In this duration, I made myself capable of doing AR follow-up in that detailed manner so the unpaid or denied claims get paid by insurance after the next finalizing of the claim. I have also experience communicating with US doctors and other third-party healthcare staff i.e. insurances, doctors, clearinghouses, and other third-party payers. I have given training to provider staff about the use of medical billing software. My priority is to be transparent with my clients regarding all the work I do.

a) Medical Billing Services includes the following: -  

1. To check Eligibility and verification of patient’s health benefits from insurance carrier’s website and through Phone.
2. Create appointments on scheduler while receiving patient calls
3. Full patient demographics and charge entry
4. Insurance claims submission (primary, secondary or tertiary)
5. Accounts receivable analysis with corrective and preventive actions and decision making for Collections
6. 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...)
7. Patient billing inquiries as per received information from provider office
8. To check claim status from insurance, websites, auto-response unit, and via live calls.
9. To make on-call appeals for reprocessing of incorrectly processed claims based on billing knowledge.
10. ICD9, CPT and HCPCS Coding and/or review, Encoder pro Expert licensed version guided for correct coding   Daily, Monthly and annual AR Financial reports preparation
11. Custom reports where required
12. Patient billing as per instructions
13. Credentialing guidelines
14. Consulting/Training
15. Super bill review
16.  Appeals\

b) Specialties

1. Internal Medicine
2. Family Practice 
3. Radiologist
4. Pain Managemen
5. Pediatrics
6. Geriatrics
7. Home Health Care
8. Behavioral

c) Billing Softwares (PM/EHR)

1. Advanced MD
2. eCW
3. Athena
4. Nextgen
5. Kareo
6. DrChrono
7. Office Ally
8. Callobrate MD
9. Practice Fusion
10. Amazing Chart
11. Praxis
12. Integrity