Zain Ashfaq

Detail-oriented Medical Billing Specialist/Manager with 10+ 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. About me- I am MBA and my Medical billing RCM experience includes: 1- Scheduling 2- Eligibility Benefits 3- Referral Authorization 4- Coding and Billing 5- Denial Management/Aging Report 6- Payment Posting 7- Credentialing services 8- Payers and Patients AR collections services. 9- Reporting and analysis 10-Audit and Consultation. By utilizing experience and skills i offer special services: Old Aging maintenance by strong follow up/Appeals. I started my carrier as Medical Biller/Coder, AR follow up - Credentialing specialist and Billing Manager. HIPAA privacy rules & compliance awareness. I have also provided my services about Healthcare Articles and news letters writing on various issues. From a Medical billing specialist, AR, EDI Analyst to Management level had almost performed all the tasks related to Medical billing. I have good communication and managerial skills, virtual assistant task via Zoom/Go to meeting, quick learner, ability to follow instructions and multitask to meet deadlines. Further I have worked with Different clients and helped Medical billing Companies as Medical biller, AR specialist, and Billing manager. As a Manager Special Projects, Manager CPI and a Strategic Analyst Financial analysis also been done for different projects. 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. A) Medical Billing Services includes the following:- - To check Eligibility and verification of patient’s health benefits from insurance carrier’s website and through Phone. - Create appointments on scheduler while receiving patient calls - 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 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 - 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 - Custom reports where required - Patient billing as per instructions - Credentialing guidelines - Consulting/Training - Super bill review – 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 delays - Suggest appropriate modifier for maximizing the revenue via Encoder pro Expert licensed version C) Billing types i have worked on: - Diagnostic, Pathology, Toxicology Labs. - Multi-specialist Doctors - Nursing Home - Home Health - Hospitals D) Softwares i have worked on: - Eclinicalworks - Kareo - AdvancedMD - Medisoft Network Professional - Care Cloud - Practice mate (Office Ally)