Hire the best EDI Specialists in Rawalpindi, PK
Check out EDI Specialists in Rawalpindi, PK with the skills you need for your next job.
- $15 hourly
- 5.0/5
- (2 jobs)
Provider Enrollment & Credentialing Specialist I am a dedicated Provider Enrollment and Credentialing Specialist with a strong track record in enhancing operational efficiency and ensuring compliance within the healthcare sector. Key Skills: Provider Enrollment Expertise in managing the full spectrum of provider enrollment processes—from application submission to follow-up and tracking—to ensure timely approvals and a seamless experience. Credentialing Skilled in maintaining current records and adhering to regulatory standards to ensure rigorous credentialing practices. Medical Staff Appointments and Privileging Proficient in facilitating medical staff appointments and securing practitioner privileges within hospital settings, ensuring compliance with hospital policies and regulatory requirements. Verification Meticulous in verifying provider credentials, licenses, and certifications to ensure accuracy and adherence to industry regulations. Reporting Experienced in generating and analyzing reports related to provider enrollment and credentialing to support decision-making and compliance audits. Communication Excellent interpersonal and communication abilities that facilitate effective collaboration with internal teams and external stakeholders. Why Choose Me: Efficiency Proven ability to streamline enrollment workflows, reduce processing times, and minimize errors for optimal operational performance. Compliance: Up-to-date knowledge of industry regulations ensures all enrollment and credentialing activities meet current standards. Experience: With 4 years of experience, I have successfully supported healthcare organizations in navigating the complexities of provider enrollment and credentialing. My experience includes working directly with hospitals to secure practitioner privileges and manage the credentialing process for physicians, non-physicians, clinical laboratories, and home health agencies. Industries Served: I have offered my expertise to various healthcare entities, including individual providers, ancillary services, facilities, and institutional healthcare providers. Let’s work together to optimize your provider enrollment and credentialing processes for maximum efficiency and accuracy. I look forward to contributing to the success of your healthcare organization.
Electronic Data Interchange (EDI)
ComplianceStatus ReportsRecords ManagementElectronic Funds TransferElectronic Data InterchangeContract NegotiationMedical Billing & CodingHealthcare - $35 hourly
- 3.1/5
- (38 jobs)
I am an EDI Developer and currently working with Sequel Systems Inc. NY. Skills • Expert in developing software solutions for X12 EDI Standards used in Commerce industry; • Full grip on transactions sets 850, 855, 856, 857, 810, 997, 999, TA1. • Analysis, Design and Develop software solutions of X12 EDI Standards used in a healthcare industry. • Development of EDI modules including 837, 835, Real-time Eligibility/Batch eligibility verification 270/271, Claim Status 276/277, 999. • Developed Custom tools for Data Migration through 837 Healthcare Claim file using Microsoft Visual Studio 2010. • Provide Technical Assistance related to EDI issues. • ACHIEVEMENTS Successful transition of EDI 4010 standard custom module into 5010 version involving, 270 Eligibility, 276 Claim Status, 837 Healthcare Claim Standards. • Successful launch of a Full scale EDI Clearinghouse used by Healthcare Providers for submitting and tracking their Claims and Payments. • CONSULTANCY I provide consultancy to Healthcare Vendors.
Electronic Data Interchange (EDI)
Cold CallingXML Web ServicesElectronic Data InterchangeElectronic Medical RecordData EntryEcommerce Website DevelopmentCare Converge Patient PortalMedical Billing & CodingSQL ProgrammingAccounts Receivable ManagementDatabase ManagementHealthcare ITAPI IntegrationMicrosoft Office - $13 hourly
- 5.0/5
- (2 jobs)
A highly competent Microsoft .NET expert with a blend of project management skills. Implemented solutions for medium to large scale corporations. Worked closely with clients to extract, model requirements and provide technical solutions. My dream is to work in highly competitive and constructive environment and leverage my technical capabilities to move the organization forward. My Technical specialties includes (but not limited to): .Net technologies, MVC,(MVVM Pattern) MS SQL Server,Entity Framework, Web Services, Web Development, Database Development, Jquery, Ajax, DevExpress, DevExtreme, Angular.
Electronic Data Interchange (EDI)
Microsoft Dynamics CRMMicrosoft Dynamics 365RabbitMQWordPressHealthcare ITElectronic Medical RecordElectronic Data InterchangeReactXamarinMicrosoft SQL Server ProgrammingSeleniumAPIDevExpressASP.NET CoreASP.NET MVC - $66 hourly
- 0.0/5
- (0 jobs)
Cutting-Edge Solutions for Health EDI & RCM Challenges As a certified Healthcare IT Strategist and Revenue Cycle Consultant, I specialize in transforming complex EDI workflows and RCM processes into streamlined, AI-powered systems. With over a decade of experience optimizing revenue cycles for US healthcare providers, I bridge the gap between technical innovation and financial performance. Why Clients Hire Me: ✅ EDI Integration & Compliance: Expert in HIPAA-compliant EDI 837/835/277/CAQH file processing, payer onboarding, and clearinghouse optimization. ✅ Denial Rate Reduction: Slashed denial rates by 35%+ for 52+ providers using predictive analytics and AI-driven root-cause analysis. ✅ End-to-End RCM Automation: Built custom Python/SQL scripts to automate 50% of manual tasks, accelerating claim processing by 30%. ✅ Staff Training & Process Upskilling: Trained 100+ teams on EHR/PM platforms, Agile workflows, and denial management best practices. Recent Projects: Designed an AI-powered denial prediction model for a 50-provider clinic, reducing aged AR by $2M annually. Integrated EDI 837/835 workflows for a telehealth startup, achieving 99.9% claim acceptance within 3 months. Led RCM digital transformation for a behavioral health BPO, cutting manual data entry by 40% via UiPath automation. Ideal Clients: Healthcare BPOs struggling with EDI errors or slow claim processing. Startups needing scalable RCM workflows for rapid growth. Clinics/hospitals seeking to modernize revenue cycles with AI/automation. Tools & Tech Stack: EDI: Edifecs, Mirth Connect, Waystar, Change Healthcare Analytics: Python, SQL, Power BI, Cognos Automation: UiPath, Power Query, Zapier RCM Platforms: Epic, Cerner, Athenahealth, eClinicalWorks Certifications: HIPAA Compliance | Agile Methodology | Advanced Excel EF SET English (C1 Advanced) | Data Science Foundations Let’s Transform Your Revenue Cycle! ➡️ Click “Invite to Job” to discuss how I can optimize your EDI workflows, slash denials, and future-proof your RCM operations.
Electronic Data Interchange (EDI)
Healthcare SoftwareRobotic Process AutomationTelemedicineData AnalyticsBusiness Process OutsourcingMicrosoft ExcelMicrosoft Power BIPreauthorizationMedical BillingProcess OptimizationeClinicalWorksHIPAAHealthcare ITElectronic Data InterchangeRevenue Cycle Management - $5 hourly
- 0.0/5
- (0 jobs)
As an expert of US Medical Billing, I bring extensive expertise in every step of Revenue Cycle Management (RCM). From Verifications of Benefits (VOBs) and authorizations to claim submissions, account receivables, and insurance follow-ups, I have a deep understanding of the complete billing process. I specialize in optimizing workflows, minimizing claim rejections, and ensuring timely reimbursements from workers' compensation, no-fault, and commercial insurance providers. With a proven track record in increasing revenue for healthcare providers, I am dedicated to helping your practice or facility streamline billing operations and maximize your earnings. My expertise is backed by years of hands-on experience, and I am committed to delivering efficient, accurate, and results-driven solutions.
Electronic Data Interchange (EDI)
Mental HealthHealthcare ManagementMedical TerminologyMedical Records ResearchMedical Equipment & SuppliesInsurancePractice FusionFinancial ReportingAccounts ReceivableElectronic Data InterchangeInsurance Claim SubmissionPreauthorizationVOBMedical Billing & CodingHealthcare Common Procedure Coding System - $10 hourly
- 0.0/5
- (0 jobs)
Experienced Credentialing Specialist with a proven track record in ensuring compliance and accuracy in credentialing processes. Detail-oriented and adept at navigating complex healthcare regulations. Committed to maintaining up-to-date credentials for healthcare professionals. **Skills:** - Credentialing and Re-Credentialing - Provider Enrollment - Verification of Credentials - Regulatory Compliance - Database Management - Attention to Detail - Communication Skills - Time Management **Experience:** *Credentialing Specialist | [Nobiltiy] | (Januray-15-2022 to August-01-2023) - Managed the end-to-end credentialing process for healthcare providers. - Conducted thorough verification of credentials, ensuring compliance with industry standards. - Collaborated with cross-functional teams to streamline credentialing procedures. *Credentialing Coordinator | [Claim Care] | [September 2023 - March 2024]* - Coordinated provider enrollment activities, ensuring timely completion of applications. - Assisted in the development and implementation of credentialing policies. - Conducted regular audits to maintain accuracy in credentialing records. *Team Lead Credentialing | Personic Health [March 2024 - Continue] **Education:** [Bachelor's/Master's Degree in Information Technology] [University of Central Punjab, 2021] **Certifications:** - Certified Provider Credentialing Specialist (CPCS) - AutoCAD **Availability:** Open to new opportunities. Contact for availability.
Electronic Data Interchange (EDI)
Electronic Data InterchangeComputer BasicsCustomer ServiceAutoCAD Civil 3D - $15 hourly
- 0.0/5
- (0 jobs)
Are billing inefficiencies affecting your practice’s cash flow? With over 7 years of experience in Medical Billing, Coding, and Practice Management, I’ve helped healthcare providers boost financial outcomes by reducing claim denials, improving reimbursement rates, and ensuring compliance. Specializing in Revenue Cycle Management (RCM), I work with solo providers, small practices, and large healthcare organizations to streamline billing, improve collections, and minimize errors. My proven expertise in Medical Billing & Coding, Denial Management, and Process Improvement ensures your practice maximizes revenue. What I Bring to the Table: Comprehensive Revenue Cycle Management (RCM) solutions. Proven ability to reduce denials and accelerate payments. Reliable, cost-effective, and compliant processes. Core Services: Eligibility Verification & Prior Authorizations: Prevent denials with thorough pre-billing checks. Clean Claim Submission & Payment Posting: Ensure accurate and efficient claim processing. AR Management & Denial Resolutions: Optimize collections and reduce outstanding balances. Insurance Credentialing & EDI Enrollments: Streamline payer setup and provider enrollments. Patient Billing Support: Deliver compassionate, professional support for patient inquiries. Key Tools & Expertise: Platforms: Practice Fusion, Kareo, AdvancedMD, Athena, Office Ally. Coding Knowledge: ICD-10, CPT, HCPCS Coding, CMS Guidelines. Specialties: Nephrology, Cardiology, Physical Therapy, Radiology, Psychiatry, and more. Why Choose Me? Specialized Solutions: Customized strategies to fit your practice’s needs. First-Time Resolution: Focused on reducing claim rejections and streamlining approvals. Efficient and Reliable: On-time delivery with precision and compliance. Specialized Experience: Proficient in managing Personal Injury, Workers’ Compensation, and Specialty Claims. Extensive work with PT, OT, Surgery Centers, and other high-demand specialties. Leadership roles in financial reporting, practice audits, and team management. Let’s discuss how I can support your practice’s financial goals while reducing stress and maximizing revenue.
Electronic Data Interchange (EDI)
Light BookkeepingFile ManagementMicrosoft OfficeData EntryAdministrative SupportCustomer ServiceMicrosoft ExcelInsurance Policy AnalysisHealthcare ManagementAccounts Receivable ManagementElectronic Data InterchangeElectronic Medical RecordICD CodingMedical Billing & Coding Want to browse more freelancers?
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