I am a Revenue Cycle Management (RCM) Consultant and Medical Billing Specialist with 7+ years of experience in U.S. healthcare billing, accounts receivable management, denial management, and credentialing.
I help healthcare providers, behavioral health clinics, private practices, urgent care centers, and multi-specialty medical organizations improve cash flow through medical billing, AR follow-up, claim denial resolution, insurance verification, prior authorization, and payment posting.
My core expertise includes:
✔ Medical Billing
✔ Revenue Cycle Management (RCM)
✔ Accounts Receivable (AR) Follow-Up
✔ Denial Management & Appeals
✔ Credentialing & Provider Enrollment
✔ Insurance Verification & Benefits
✔ Prior Authorization
✔ Claims Submission (CMS-1500 / UB-04)
✔ Payment Posting & Reconciliation
✔ Medical Coding Support
✔ KPI Reporting & Revenue Analytics
✔ EHR / EMR Workflow Management
I specialize in identifying revenue leakage, aging AR, recurring denials, underpayments, delayed reimbursements, and billing workflow inefficiencies.
My services help practices with:
* faster collections
* lower denial rates
* improved clean claim ratio
* optimized AR recovery
* streamlined credentialing
* better revenue reporting
* scalable billing operations
If you need support with medical billing, revenue cycle optimization, AR cleanup, denial prevention, credentialing, or RCM consulting, I can help improve your financial operations and maximize reimbursements.
Let's Connect.
Expert RCM Provider | Revenue Cycle Management Expert | Medical Billing Specialist | AR Recovery & Follow-Up Expert | Denial Management Consultant | Credentialing Specialist | Insurance Verification & Prior Authorization Expert | Claims Submission & Payment Posting Specialist | Healthcare Revenue Optimization Consultant |Expert RCM Provider | Medical Billing | AR Recovery | Denial Management Revenue Cycle Management (RCM), Medical Billing, AR Follow-Up, Accounts Receivable Recovery, Denial Management, Credentialing, Insurance Verification, Prior Authorization, Claims Submission, Payment Posting, Revenue Optimization, Healthcare Operations, Billing Workflow, Revenue Reporting, EMR / EHR Support
Fractional Billing Director
RCM Strategy Consultant
Revenue Optimization Partner
Healthcare Operations Consultant
Billing Process Consultant
Revenue Growth Consultant
Practice Profitability Expert
Claims Denial Prevention Consultant
End-to-End RCM Solutions
Full Cycle Medical Billing
Claims Processing Expert
AR Follow-Up Expert
Denial Resolution Specialist
Payment Posting Specialist
Insurance Verification Expert
Prior Authorization Specialist
Revenue Optimization Consultant
Billing Workflow Expert
Expert RCM Provider
Revenue Cycle Management Expert
Medical Billing Expert
RCM Consultant
Billing Operations Specialist
Healthcare Revenue Expert
AR Recovery Specialist
Denial Management Expert
Credentialing Specialist
Medical Claims Expert
Electronic Medical Record
Medical Billing & Coding
ICD Coding
Medical Condition Coding
Healthcare Common Procedure Coding System
Medical Procedure Coding
Medical Billing
Medical Transcription
Electronic Health Record
Preauthorization
Insurance Verification
Insurance Claim Submission
Accounts Receivable Management
EMR Data Entry
HIPAA
Medical Mastermind Medical Billing Services
Vicky C.
Vadodara, India
$7/hr
4.6
154 jobs
End to End Medical Billing and soft collections in flat rates. Services include Credentialing, Charge Entry, AR follow up, Denial Management and Reporting
(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). Specialties
Anesthesiology
Cardiology
Chiropractic
Dermatology
Emergency Medicine
Endocrinology
Family Practice
Gastroenterology
General surgery
Geriatrics
Gynaecology and obstetrics
Internal Medicine
Pneumology
Orthopaedic
Otolaryngology
Pathology
Pediatrics
Physical Medicine and Rehabilitation
Physical Therapist
Psychiatry
Neurology
Radiology
Radiotherapy
Rheumatology
Urology
Electronic Medical Record
Medical Informatics
Virtual Assistance
Customer Service
Medical Mastermind Medical Billing Services
Medical Condition Coding
Insurance Claim Submission
Accounts Receivable
Insurance Consulting
Medical Procedure Coding
Healthcare Common Procedure Coding System
Healthcare Management
ICD Coding
Medical Billing & Coding
Automation
Shamaque S.
Azamgarh, India
$25/hr
5.0
6 jobs
Healthcare Integration & Product Development:
I specialize in designing and delivering end-to-end healthcare interoperability and digital health solutions. My expertise includes integrating EHRs, EMRs, RIS, LIS, Telehealth platforms, RPM systems, AI applications, Medical Devices, laboratory analyzers, and LIMS using HL7 v2, FHIR R4, REST APIs, JSON, XML, RS-232, COM, CCDA, and CDA.
Beyond integrations, I now focus on Healthcare Product Development and Solution Architecture, designing scalable healthcare products from concept to production. I have planned complete healthcare data flows, interoperability strategies, and cloud architectures while ensuring HIPAA-compliant, secure, and scalable solutions.
I have designed AI-powered healthcare workflows including Appointment Scheduling AI Agents, Medication Refill AI Agents, Clinical Workflow Automation and healthcare data integration platforms.
I am also experienced in building SMART on FHIR applications that launch applications directly from leading EHRs such as Epic, Cerner, Athenahealth, Practice Fusion, eClinicalWorks, Meditech, and Veradigm (Allscripts) etc using SMART on FHIR, OAuth 2.0 and OpenID Connect.
Additional Expertise:
RPMS (Remote Patient Monitoring System) workflow design and integration with leading EHR/EMR platforms. Experience making RPM/RPMS platforms SMART on FHIR enabled for seamless EHR launch and interoperability.
IoT healthcare integrations with medical devices including Anesthesia Monitors, Lab Analysers, Patient Monitoring Devices, and Diagnostic Equipment using Serial (RS-232/COM Port), TCP/IP, HL7, and vendor-specific communication protocols.
Expertise in deploying, configuring, securing, and managing NextGen (Mirth) Connect / BridgeLink environments from development through production.
Skilled in healthcare data transformation and mapping across HL7 v2, FHIR R4, CCDA, CDA, XML, JSON, CSV, and custom formats mean extensive experience converting HL7 ↔ FHIR, CSV ↔ FHIR, XML ↔ HL7, JSON ↔ FHIR, and custom healthcare data formats.
Experienced in developing custom healthcare middleware using Node.js and Express.js for enterprise integrations along with HIPAA-compliant application design, PHI protection, secure API development, encryption, audit logging, and access control.
• Experience integrating AI applications and healthcare automation workflows using HL7, FHIR, and REST APIs.
Hands-on experience with Azure, AWS, Docker, Kubernetes, Linux, and cloud-hosted healthcare integration platforms.
Experienced in designing enterprise healthcare data flows from patient registration through clinical documentation and provider workflows and ETL into FHIR Server.
Extensive experience designing and integrating FHIR R4 resources including Patient, Encounter, Observation, Condition, Medication, MedicationRequest, Appointment, Clinical Notes, DiagnosticReport, Procedure, AllergyIntolerance, CarePlan, Practitioner, Organization, and DocumentReference
---
Core Expertise
Healthcare Integrations
* HL7 v2, FHIR R4, SMART on FHIR
* REST APIs & Healthcare APIs
* CCDA, CDA, XML, JSON, CSV
* Healthcare Workflow Automation
* Interoperability Architecture
* AI-powered Healthcare Integrations
Healthcare Product Development
* Product Architecture & Solution Design
* Healthcare Workflow Planning
* Technical Product Development
* AI Healthcare Products
* Clinical Data Flow Design
* Healthcare SaaS Platforms
Middleware & Integration Engines
* NextGen Mirth Connect, BridgeLink, Rhapsody, Azure Logic Apps, MuleSoft, Custom Node.js Middleware
Programming & Cloud
Node.js, Express.js, JavaScript, PostgreSQL, MS SQL Server, Microsoft Azure, AWS, Docker, Kubernetes
---
EHR & Healthcare Systems
Worked with:
Epic, Cerner Millennium, Athenahealth, eClinicalWorks (eCW), Veradigm / Allscripts, Practice Fusion, TouchWorks, AdvancedMD, Tebra, Elation Health, NovaRad and Meditech etc.
FHIR Platforms:
HAPI FHIR Server, Medplum, AWS HealthLake and Amazon FHIR Server
---
EDI Expertise :
Experienced with HIPAA-compliant EDI integrations supporting ANSI X12 (4010 & 5010), including:
837 Claims, 834 Enrollment, 270, EDI 271, 835 Remittance and Payroll & 401(k) Processing
---
Why Work With Me?
✔ 6+ years of Healthcare IT experience
✔ Successfully delivered healthcare integration projects from POC to Production
✔ Strong expertise in SMART on FHIR, HL7, FHIR, AI Healthcare Solutions, and Enterprise Integrations
✔ Experienced in Healthcare Product Architecture, Technical Product Development, and Interoperability Strategy
✔ Able to bridge Product, Clinical Workflows, Business Requirements, and Engineering Teams
Whether you need a Healthcare Integration Architect, SMART on FHIR Developer, Healthcare Product Developer, or Technical Product Owner, I can help design and deliver secure, scalable, and production-ready healthcare solutions.
Electronic Medical Record
Mirth Connect
Health Level 7
HIPAA
JavaScript
SQL
FHIR
REST API
Electronic Health Record
JSON
XML
Web API
ETL
Medical Imaging
Node.js
ExpressJS
Arpit C.
Nagpur, India
$49/hr
4.8
53 jobs
Experienced of working in SAAS platform . I have a good experience in developing Server-less applications and Micro-services using AWS Lambda, AWS API Gateway, AWS Cognito and AWS S3 with serverless framework.
Interoperability Solutions
CUMC University - New York, ( 2 years project )
● Connecting Medical university with External Labs and Primary Care clinics
● Mirth connect HL7- ADT, ORM , SIU message transmission
● DFT for daily billing generation
● EMR customisation - Neurology
● Database performance tuning
Delaware Diagnostic Lab- Delware,
● Built a LIS system
● Integration with HEX Labs / QUEST Labs
● ORU and ORM messages
● COVID 19 lab - result generation
● Analytics and BI reports - Dashboard
Vistacan EMR - Whitefoot clinic - BC Canada,
● EMR integration Pharmacies
● Customisation of EMR with forms
● eRX - with pharmacies
● SMS/Fax services from Clinic to Lab, Pharmacy and Patient
AXAOnehealth - Egypt
● Deployed customised EMR solutions for 6 clinic
● Acted as Business analyst to build a comprehensive EMR
● Integration with Egyptian Labs using Mirth Connect and HL7
● Multi specialty - EMR , Advanced KPI for CDS
● Trained doctors , nurses - gathered requirements - translated to Business needs with tech team.
EMR Customization & Integrations
● OpenEMR Customization -
○ Ophthalmology ,
○ Neurology ,
○ Family Medicine ,
○ Dentistry ,
○ OBG,
○ Paediatrician,
○ Physiotherapist
RCM - Revenue Cycle Management Development
● US Billing cycle - implementation
● Eligibility check using X12 - Real time
● Claim and Billing integration with medicare / medicaid insurance companies
● Dashboard for analytics
● Claim scrubbing
● EDI - integration with Clearing houses in U.S
We program entirely on SOA with code structure based on Restful APIs, especially with Cloud based applications (AWS, Azure, Rack space, Google cloud). We work on agile methodology with daily or weekly scrum meeting to meet client’s expectations.
I am willing to sign NDA before any proceedings as I understand that the security and confidentiality of your product holds the utmost importance.
With deep knowledge of .NET framework including Asp.Net MVC 4/5, .Net Core, Web API, C#, EF, KnockOut, Angular, Bootstrap, HTML5, CSS3, JQuery, SQL, have involved in handling many aspects of the application, including but not limited to performance, scalability, security and designing service oriented architecture following SOLID principles.
Expertise in techstack and Industry best practices we follow:
* Responsive UI development by using React Js +Redux, React native + Redux, API Service integration, SQLite, Firebase, JSON parsing, web Service.
* Advanced analytical skills, in-depth knowledge of the Software Development Life Cycle (SDLC).
* ASP.Net, C#, .Net Core, MVC.
* Angular 8+, React.JS, JavaScript, jquery.
* Secure Rest API calls, session token using OAuth authentication and basic browser authentication.
* Ability to create complex RESTful API services with automated documentation using .NET.
* Bootstrap, HTML5, LESS, Regular expressions.
* Database: MS SQL, SQL Azure, PostgreSQL, MongoDB, DynamoDB and MySQL.
* Entity framework, MS Azure App service, Razor Engine, MS WIndows Azure, MS Active Directory, MS Azure blob services.
* Writing reusable libraries with proper usage of OOPs, design scalable, loosely coupled and highly testable service-oriented architecture following SOLID principle.
* Database design, query optimization, query execution plan review, indexing, normalization/ denormalization, stored procedure, views, SSRS, SSIS and SSAS.
* Unit test development for the front as well as back end – Jasmine, Karma, MsTest, nUnit, xUnit, mocking framework – Typemock, moq, rhino
* Proficient understanding of code versioning tools – TFS, SVN, Git – Pull/ push/ commit, branches/ shelve changes, etc.
* Sprint based delivery and retrospective meetings to improve via effective project management tools like Jira, Trello, Asana, basecamp etc.
* CI/CD – Jenkins, AWS, GitLab, DevOps
Keywords: web application developer, web app developer, SaaS developer, ERP developer, CRM developer, eCommerce developer, platform developer, MVP developer, startup developer, API developer, marketplace developer, software architecture, database architecture, software engineer, web programmer.
Electronic Medical Record
.NET Framework
RESTful Architecture
Web Development
FHIR
HIPAA
Healthcare Interoperability
eClinicalWorks
Health Level 7
Telemedicine
Mirth Connect
Electronic Data Interchange
Epic Systems Medical Software
SNOMED-CT
LIMS
Ravindra K.
Pune, India
$25/hr
5.0
4 jobs
Greetings! 😊
Welcome to my profile! 👋
With over 7+ years of experience in the development and management of healthcare solutions, I specialize in delivering HIPAA-compliant solutions using cutting-edge technologies. From telemedicine platforms to EHR integration, I’ve built solutions that improve patient care and streamline healthcare management. 💡
💼 Healthcare Solutions Expertise:
Telemedicine Platforms: HIPAA-compliant solutions with video consultations, appointments, e-prescriptions, and medical notes 🩺
Remote Monitoring & Diagnostics: Integration with devices like Fitbit, GoogleFit, iHealth, and more for seamless health tracking 📊
EMR/EHR Management: Full integration and interoperability with systems like FHIR, HL7, and Epic 🔗
On-Demand Pharma Delivery & ePrescribing: Integration with major pharmaceuticals 💊
Clinical Decision Support: Helping clinicians make data-driven decisions 📈
🛠 Technology & Standards Expertise:
Backend: Java, Spring Boot, NodeJS, Express, Loopback, Microservices 🔧
Frontend: ReactJS, Angular, JavaScript, HTML, CSS 🌐
Databases: PostgreSQL, MySQL, MSSQL 🗄️
Healthcare: EHR/EMR, FHIR, HL7, ICD-10/11, SNOMED, C-CDA 🏥
Video Conferencing & Messaging: WebRTC, Twilio, SendGrid 📹
What I Can Do for You:
Build custom healthcare management solutions tailored to your needs 🏥
Develop telemedicine platforms for consultations, prescriptions, and more 🩺
Integrate with third-party APIs and ensure smooth communication with healthcare systems 🔄
Help you stay compliant with HIPAA, PHIPA, and other healthcare standards 🛡️
Create robust hospital management software 🏨
Why Work With Me?
✅ A real expert with hands-on experience in the healthcare industry 🧑💻
✅ No micromanagement – I get things done with minimal oversight ✨
✅ Reliable & dedicated to the success of your project 🤝
✅ You’ll enjoy the process with a partner who cares about the result 💬
Your ideas are invaluable, and their implementation should be just as exceptional. I’d love to partner with you and take your healthcare project from concept to reality. Let’s connect and discuss how we can work together to fully meet your business needs! 🌟
Cheers! 🎉
Electronic Medical Record
Web Service
API Integration
Electronic Health Record
Telemedicine
FHIR
HIPAA
Node.js
Python
Java
Amazon Web Services
Next.js
React
AI Development
TypeScript
Sanjay K.
Chamba, India
$10/hr
4.8
14 jobs
RCM specialist (Medical Billing & Coding)
Over several years of experience in End to end, Medical Billing includes claim submission, AR follow-up, dead collections, Patient calling, Patient AR follow-up, denial management, analyzing the patient's account and sending the patient statement accordingly, credentialing Benefits verification, and much more. In dept knowledge of HIPAA Compliant ensure the highest standards of security and confidentiality.
Managing all issues related to Billing, Coding, Payments, and follow-up, etc. Aforementioned details :
• Conducting Interviews.
• CSR.
• Patient Billing.
• Insurance Billing.
• ERA’s posting.
• EOB’s posting.
• Patient payments (included statements).
• ERA’s & EOB’s denials.
• ERA’s setup.
• Making new web logins.
• Software & Clearing House Rejections.
• Eligibility Verification (utilizing web portals, IVR & live calls.)
• Claim status (utilizing web portals, IVR & live calls.)
• Provider Enrollment status (Also enrolled new location for contracting providers)
• Emails processing.
• Follow up on unpaid & denied claims.
• Training for new resources.
• Assisting staff.
• Daily reporting.
• Appeals for late filing, medical records, prime EOB to secondary & Medical necessity etc.
Softwares:
I’m good at using different Billing cloud base software. Like:
• Advanced MD.
• Office Ally.
• Collaborate MD.
• ECW (E-clinical Works).
• Athena Net
• Care Tracker
• Icanotes
• Kareo
• Medisoft
• CareCloud
• Emdeon EHR/EMR system
• EPM (Electronic Practice Management).
I have worked on the following specialties like:
• Internal Medicine.
• Family Medicine.
• Chiropractic
• Gastroenterology.
• Cardiology.
• Radiology.
• Oncology.
• Ophthalmology.
• Acupuncture etc.
• Physical Therapy et
I have also experience communicating with US doctors and other third-party healthcare staff, i.e., insurances, doctors, clearinghouses, and other third-party payers.
Lead Generation I Online Research I Web Researcher
I am experienced in scraping emails and other contact details of targeted individuals, industry or businesses. My skill is to find targeted people contact details which includes finding key persons and executives of huge business or firms along with their credentials that include their "First Name, Last Name, Title/Designation, E-mail, Phone/Direct Dial, Address and LinkedIn profile links" using different online tools like LinkedIn, Data.com, One Source, and FindTheCompany.
My core competencies lie under Lead Generation, Linkedin Search, List Building, Data Entry (Zoho, Sugar CRMs and others), Web Research/Data Mining, US Real Estate, Microsoft Office tools, EMAIL SEARCH (via Zoominfo, Rapportive, SellHack, Toofr, data.com, and Email Hunter).
What can I do for you:
# Email/Contact List building
# Linkedin lead generation( Premium Sales Navigator account)
# Research and Data Collection,
# Database Creation
# Internet Research
# Web Research
# Administrative Support/ Office Admin(Backend)
# Data Entry
# Boolean searching
# Social Media Research
# Data Scraping including Event research, Blog research, Website research, Image
research, eBook research, Youtube research
# Finding useful information
# Extracting email address & other related contact information
# Google Docs, Google Spreadsheet, Google Document
# Salesforce
# CrunchBase
# CRM
Tools I`m familiar with:
1. Linkedin(Premium)
2. Lead411 (Premium)
3. Spokeo (Premium)
4. Google search
5. Paid and free Directories
6. Social Media research
7. Yellowpages
8. Yelp
9. Manta
10. YP
11. Directories
12. Google
13. Facebook
14. Instagram
15. Pinterest
16. YouTube
I am looking for opportunities to build a long-term relationship with my future employers and to build myself a good reputation through my diligence, hard work, and top-quality service. I take privacy very seriously, and I respect my previous clients. While I am not at liberty to add these projects to my portfolio, my former firm is more than happy to verify and recommend my work.
If you have any questions, please feel free to contact me at any time.
Thank you for taking the time to visit my profile, and I look forward to hearing from you!
Thanking
With Regards,
Sanjay
Electronic Medical Record
Medical Records Research
Accuracy Verification
List Building
Data Entry
Microsoft Excel
Lead Generation
Online Research
Google Sheets
Medical Procedure Coding
Medical Billing & Coding
WordPress
Lead Generation Strategy
EMR Data Entry
Lead Generation Analysis
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