I have worked as a Medical Biller and Denials Specialist in US Medical Billing healthcare companies.
I have worked for 10+ years in a US Healthcare Business. From a Medical billing specialist, Account Receivable, EDI Analyst to Management level had almost performed all the tasks related to Medical billing.
I was part of the company's top management so in that way mostly involved in making marketing strategies and guiding marketing executives in their projects. The financial analysis has also been done for different projects. I have also experience communicating with US doctors and other third-party healthcare staff i.e. insurances, doctors, clearinghouses, and other third-party payers.
A. MEDICAL BILLING SERVICES
- Eligibility & Benefits verification.
- Appointments Scheduling.
- Credentialing guidelines with payers.
- Patient Demographics and Charge entry.
- Insurance claims submission via clearinghouse and Paper submission.
- Accounts receivable and Denial management.
- Payment Posting.
- Patient billing for PR -1,2,3 and PR 96 and PR 119 etc.
- Claims F/U on denials from insurances like Workers Comp, Medicare, Medicaid, BCBS, Managed care, and Commercial Insurances (Aetna, BCBS, Cigna, UHC, Oxford, etc...)
- Claim status from insurance Portal and calls.
- Submitting appeals for denied claims.
- ICD 10, CPT, and HCPCS Coding review.
B. SPECIALITIES
Durable Medical Equipment, Optometry and Ophthalmology, PHYSICAL THERAPIST, Chiropractic, Acupuncture, Behavioral Health, Ambulatory Surgery, Home Health, Anaesthesiology, Cardiology, Skilled Nursing Facility, Dermatology, Emergency Medicine, Endocrinology, Family Practice, Gastroenterology, General Surgery, Internal Medicine, Orthopedic, Otolaryngology, Pathology, Pediatrics, Physical Medicine and Rehabilitation, Psychiatry, Radiology, Podiatry, Radiotherapy, Rheumatology, Urology
C. PMS SOFTWARE WORKED ON:
Simple Practice, AdvancedMD, Carecloud, Practice EHR, RXNT, Kareo, Office Ally, Docutap, Therabill, ECW, EZclaim, ClinixPM, Ethomas, Medisoft, Criterions, Dr. Chrono, Athenanet, , Medisoft, Carecloud,
D. CLEARING HOUSE WORKED ON:
Trizetto, Optum EDI, Availity, Apex, Zirmed, Emdeon
E. EHR/EMRs WORKED ON:
Kareo EHR, Webpt, Practice Fusion, HelloNote
I believe in hard work and honesty. I am always interested in making long-term professional relationships with my clients and will never complete the project until the client is 100% satisfied.
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HIPAA
Data Analysis
Google Sheets
eClinicalWorks
Insurance Verification
Healthcare Common Procedure Coding System
Report Writing
Account Reconciliation
ICD Coding
Electronic Medical Record
EMR Data Entry
Medical Billing & Coding
Medical Records Research
Medical Records Software