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based on 661 client reviews
  • $18 hourly
    Experienced in both Medical Billing and Dental Billing with over 8 years of in-depth experience in the health care industry. I am a High level biller that is able to manage accounts and provide support to my clients and owns Billing PROtect. Promoted twice as a Lead Medical Biller handling 2 practices by myself and a Dental biller for 2 Departments (Billing & Financial Department) for 2 locations. I also have a background in Customer service and worked at the same time as a technical-support representative. Open for an interview if needed! Medical & Dental Billing Services: • Submitting Prior-Authorization/Pre-determination including the use of NEA FastAttach, Continuation of Care, creating narratives, and request for credentialing. • Check Eligibility and verification of patient’s health benefits from insurance carrier’s website or through phone call verification. • Patient scheduling • Full patient demographics and charge entry. Processing of Recurring payments for different mode of payments including credit cards and etc. • Insurance claims submission (primary, secondary or tertiary) • Payment Posting for EFT/ERA, cheque, or other forms of payment including Recoupment from insurance companies • 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, front desk, treatment coordinators, MA's, and from the doctor • 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, ICD10, CPT and HCPCS Coding and/or review • Daily, Monthly and annual AR Financial reports preparation • Custom reports if required • Patient billing as per instructions • Credentialing guidelines • Consulting/Training • Super bill review • Appeals Medical & Dental Coding: • To identify and research the right DX and CPT code according to medical records and treatment selected by patients for dental billing. • 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 and supercoder
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    ICD Coding
    Administrative Support
    Medical Mastermind Medical Billing Services
    Accounting
    Ecommerce Website Development
    Medical Translation
    Medical Procedure Coding
    Electronic Medical Record
    Customer Support
    Technical Support
    Customer Service
    Data Entry
    Medical Billing & Coding
  • $15 hourly
    I'm a seasoned medical virtual assistant based in the Philippines with quite a diverse background. My experience ranges from working alongside mobile, clinic-based, and concierge physicians specializing in family medicine, internal medicine, metabolic medicine, ophthalmology, to neurology. My main goal is to build strong professional relationships based on honesty and integrity. While I'm known for my strong work ethic, I also make sure to keep that work-life balance in check. I've got a bunch of services up my sleeve that I'm pretty good at. Think handling phone calls and email inquiries, sending out those all-important appointment reminders right on time, keeping patients' medical records up to date and super organized, managing electronic files like a pro, and smoothly coordinating jam-packed appointment schedules. Oh, and I'm on top of processing prior authorizations, helping with prescription refills, and making sure medical records, imaging, and lab orders get where they need to via fax. I'm also a champ at diving into comprehensive insurance verifications. When it comes to Electronic Medical Record (EMR) systems, I've got hands-on experience galore. I've tackled platforms like Kareo, Practice Fusion, GE Centricity, iCanotes, MDLand iClinic, IntelleChart, Amazing Chart, Athena, and eClinicalWorks. And hey, I'm no slouch when it comes to Home Medical Equipment (HME) and Durable Medical Equipment (DME) software – I'm all over Fastrack and Bonafide. But wait, there's more! Beyond my medical expertise, I've spent a good seven years as a customer service representative. I'm your go-to guy for smoothing out customer interactions – I'm all ears for their concerns, and I make sure to give them the lowdown to address their questions pronto. And if there's a snag, you bet I'll sort it out quick. I've also got a knack for escalating stuff to the higher-ups when needed. Plus, rest assured, I treat confidential info like gold and go that extra mile to keep customers smiling. If my mix of skills and experience sounds like your cup of tea, don't hesitate to drop me a line. I'm stoked about the chance to see how I can chip in and help you reach your business goals. Cheers!
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    Data Entry
    Medical
    Phone Communication
    File Management
    Microsoft Excel
    Microsoft Word
    Communications
    Email Communication
    Medical Billing & Coding
    Online Chat Support
  • $35 hourly
    Healthcare Credentialing and Rate Negotiations SERVICES: Medical Office, Data Entry, Credentialing - Health Plans - Private Practice - Hospitals - Start Up Consultations and More -
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    Email Communication
    Customer Service
    Insurance Consulting
    Administrative Support
    Medical Billing & Coding
    Communications
  • $20 hourly
    • I am specialized in all aspects associated with revenue cycle management. Sound background in Medical Billing industry and have been doing this for 11 years. • Distinguished medical billing specialist with great AR collections expertise. I love medical billing & collections because I like to win. Collecting money is a competition with the insurance company & my knowledge bank. I have collected millions of dollars on claims that providers had given up on. • Highly organized, accomplished, detailed oriented and focused professional medical billing manager Dynamic problem solver with proven effectiveness in identifying system inefficiencies and implementing corrective measures to improve cash flow. • Looking forward to helping providers, Labs, companies with their Medical Billing well as, Revenue Cycle Management needs. • Sound knowledge of RCM, Electronic Health Records (EHR) software, Medical Billing for medium to large healthcare clients, Business Analysis, Data Analysis, Reporting. • My top skills are Claims Submission, Claim Management, AR, Credentialing, Reporting.
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    Phone Communication
    EMR Data Entry
    Virtual Assistance
    Scheduling
    Microsoft Excel
    Medical Report
    ICD Coding
    Practice Fusion
    Electronic Medical Record
    Healthcare Common Procedure Coding System
    Data Entry
    Microsoft Office
    Medical Mastermind Medical Billing Services
    Medical Billing & Coding
    Accounts Receivable
  • $15 hourly
    My field of expertise is with US Healthcare. I am very comfortable with the following: * checking eligibility & benefits * identifying insurance just by looking at the plan id prefix or format *capitation *appealing claim denials and underpayments to the extent of filing an State appeal *Credit balance, refunds/recoupments *ERA/EFT enrollment *payment negotiation through Multiplan *claims submission to both primary & secondary insurance -both electronic and paper *resolving rejected claims. *preparing weekly and monthly revenue report *billing patient for copay, deductible and coinsurance The multi-tasking...all-around virtual assistant is ME.
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    Electronic Medical Record
    Data Encoding
    Accounts Receivable Management
    Healthcare & Medical
    Customer Service
    Data Entry
    Medical Billing & Coding
  • $10 hourly
    Niel is an expert and has a total of 5 years of experience as a Customer Service Representative/Technical Support Representative, Customer Retention Specialist. 1 year of experience as a Dental Insurance Customer Service Consultant and Quality Assurance Analyst in Customer Sucess Reputation Management. Joined Opencare care in January of 2021 started as an Insurance Verification agent and was promoted as Quality Assurance Analyst for RCM IV Team a few months after. Customer Service Representative/Technical Support Representative (BELL CANADA - Canada's largest telecommunications) He provided support and manage large amounts of incoming phone calls, handle customer complaints, provide appropriate solutions and alternatives, build sustainable relationships and trust with customer accounts through open and interactive communication, Communicate technical information in an accessible manner to non-technical employees. Customer Retention Specialist (BELL CANADA - Canada's largest telecommunications) He was responsible for processes orders, prepares correspondence, and fulfills the needs of existing customers that are at risk of canceling services or orders. Addresses complaints to increase satisfaction and secure renewals or saves. ===================================================================== Niel is also an expert as a Dental Insurance Customer Service Consultant worked with MetLife based in the Philippines. His role includes answering customer or provider inquiries on coverages, limits and deductibles, relay claim status, contract terms, conditions and exclusions to customers or providers. Explain reports of claims and communicate reports of investigation to the provider, forward all filed claims to the appropriate department for handling, processing and payment. ===================================================================== Niel also worked with Opencare as an Insurance Verification agent and work his way up and become the pilot Quality Assurance Analyst for RCM IV Team. He supported the business operation by identifying areas of growth and common challenges that occur in the insurance verification process, Audit insurance verifications proactively and retroactively, report on findings in a clear and organized fashion, promote organizational efficiency and identify training, error root cause and coaching opportunities for the Insurance Verification team. ===================================================================== SET OF SKILLS - Excellent communication skills, both written and spoken - Strong phone and verbal communication skills along with active listening - Meet personal/team qualitative and quantitative targets - Ability to communicate technical information to non-technical employees. - Familiarity with CRM systems and practices - Excellent problem-solving and troubleshooting skills - Ability to multi-task, prioritize, and manage time effectively - Ability to effectively execute tasks in a high-pressure environment - In-depth knowledge of insurance products and policy schedules - Ability to explain detailed policy concepts in a simple way - Expert in using Practice Management System (PMS) Dentrix, Eaglesoft, and Open Dental - Provide accurate, valid and complete information by using the right methods/tools - Experienced in using Practice Management Systems - Dentrix, Open Dental, Eagle Soft. - Tools: Salesforce, Social Studio, EvaluAgent, Outlook, MS Teams. CLIENTS FEEDBACK "Niel is a wonderful colleague to work with. He's smart, dedicated and is able to follow instructions very well even with minimal supervision. The quality of the work he does is phenomenal, which is why he is one of the best candidates to have been promoted as a Quality Assurance specialist. We're happy to have you as part of the management team!" - Opencare TRAVELS *Philippines - Negros, Panay, Leyte, Cebu Regions, *Thailand *Vietnam *Cambodia *Laos
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    Medical Billing & Coding
    Computer Skills
    Accuracy Verification
    File Maintenance
    Customer Service
    Data Entry
    Phone Communication
    Customer Retention
    Quality Assurance
    Google Workspace
    Form Completion
    Email Communication
    Technical Support
    Online Chat Support
  • $25 hourly
    I am a Sr. Software Developer working for Healthcare IT solutions for over 8 years with experience developing applications for multiple industries. The projects' scope varies from simple to Enterprise level n-tier applications. I have exceptional team management skills and get along with clients smoothly to understand and transform their business ideas into efficient software solutions. I pay particular attention to the client's business perspective to analyze and design the easiest workflow to overcome undue complications. I am skilled in Software Development, Application Development, ETL, Reporting Services, Cascading Style Sheets (CSS), and Website development. Strong engineering professional with a Bachelor's degree in Computer Software Engineering from Beaconhouse National University. The projects I have worked on them are listed below: EHR (Electronic Health Record), EMR (Electronic Medical Record), PMS (Practice Management System), and Lab Integration Frameworks for Inbound and Outbound communication. Scheduler, HRM (Human Resource Management), HIS (Hospital Information System), Pharmacy System, DWC Exchange (Claims, Division of Worker's Compensation), Clinical Quality Measures, HL7, CCDA, FHIR etc.
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    Database
    Healthcare Software
    Health Level 7
    Mirth Connect
    FHIR
    Healthcare Interoperability
    Healthcare IT
    HTML5
    HL7
    jQuery
    ASP.NET MVC
    ASP.NET Web API
    C#
    Web Development
    Web Application
  • $10 hourly
    Hi, I'm Mia Jane Lacorte, I have been working with BPO company for a bit long time already. I am hardworking, responsible, trustworthy and dedicated to work, also passionate about helping clients make their mark reach their target market on whatever business they are in. I take into consideration the client, who they are targeting and who they will benefit from.I am task-oriented and I am addicted to ticking off tasks on my to-do-list. I understand that you really need an experienced, fast and reliable, I believe I can do this type of work based on my experienced and my knowledge and I am good on computer, know how to use any MS office, an organized individual, fluent in English, committed and a problem solver. I can start as soon as possible. Job Responsibilities: : Patient Registration/patient management. : Eligibility and benefits verification. : Claim submission. : Obtaining prior and retro authorizations. : Applying payments to accounts from ERA/EOB/websites and also patient payments. : Aging report/Followup/Appeals. : Customer services and administrative assistance. : Denial management.
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    Clerical Procedures
    Communications
    Data Entry
    Medical Billing & Coding
    Google Docs
    Medical Records Software
    Scheduling
    Data Analysis
    Medical
    Accounts Receivable
    Medical Translation
    ERP Software
    Administrative Support
    Accuracy Verification
  • $25 hourly
    I am a AAPC certified Medical Coder (CPC) and Biller with expertise in multiple practice management softwares. I work on upwork projects and run Medical billing business for small practices. I follow HIPAA regulation and industry practices in Medical billing. I enjoy working with people and have extensive knowledge in denials, appeals and grievances. I am organized and give importance to accuracy and timely completion and can to be your to go person for any Medical Practice Management services. Services Offered: Complete Medical Practice Management Patient Demographics Projects - Data Entry Practice Management Migration projects Medical Coding - ICD-10, CPT (E/M) and HCPCS Provider credentialing Denial Management Revenue Cycle management Practice Management Softwares - Kareo, Advanced MD, Office Ally - Practice Mate and others Please send me a message about your project I assure that you would get your expectations met. Thanks
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    Healthcare Common Procedure Coding System
    Electronic Medical Record
    Medical Condition Coding
    ICD Coding
    Virtual Assistance
    Medical Procedure Coding
    Healthcare Management
    Office Administration
    Social Media Account Setup
    Medical Mastermind Medical Billing Services
    Medical Billing & Coding
    Accounts Receivable
    Medical Translation
    Microsoft Office
    Medical Records Software
  • $24 hourly
    Hello Upwork Clients, My name is Vivian. I am a diverse, virtual admin specialist here on Upwork who enjoys working with Upwork clients performing a variety of different general admin-related and specialized work tasks for Business, Real Estate, Healthcare, and International clients based on their VA job requests. Upwork Talent Specialists and clients send me their Invitation to Interview with them for their job posting and all requests are reviewed to be within the scope of my VA expertise, capabilities, and long-term potential. General Administrative Order processing/Invoicing, Web Research, Data Entry, Customer Service, Real Estate Admin, Marketing, Secretarial/Clerical, and Special Project work tasks upon request. Medical Biller Full cycle bi-coastal medical biller has years of work experience with New York, New Jersey, and California insurances and can help you with fixing EOB errors and payment posting, calling insurance companies for insurance verification, authorizations, payment posting and claims follow-up, and more for medical billing and coding work tasks. Accounting/Bookkeeping Virtually able to help you with maintaining your financial records on a monthly basis processing accounts receivables, payable, payroll, journal entries, statement reports, and more to balance and close the books every month. Special requests for setting up your books or changing accounting systems are also welcomed. Dependable to Do Your Work Correctly, Deliver The Work to You Timely, and Save You Money! Your Work is Confidential and 100% Guaranteed.
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    Online Chat Support
    Customer Service
    Accuracy Verification
    Administrative Support
    Upwork
    Accounts Payable Management
    Accounts Receivable Management
    Medical Billing & Coding
    Bookkeeping
  • $15 hourly
    I'm a Certified Professional Coder, Certified Medical Reimbursement Specialist, Certified Medical Coding Instructor, Certified Risk Adjustment Coder and Certified Professional Medical Auditor. I have more than 10 years of experience about the US RCM process. I have experience to Facility, Office, Home Health, HCC & Ambulance coding. I'm looking for jobs that will perfectly match my credentials. I'm fluent in English and I have a fast Internet connection.
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    Augmented Reality
    Insurance Policy Analysis
    ICD Coding
    Medical Condition Coding
    Medical Transcription
    Customer Service
    Medical Billing & Coding
    Nursing
    Revenue Management
    Data Entry
    Data Analysis
  • $30 hourly
    Hello, My name is Alijeh and I am multifaceted individual with experience in Healthcare, Business, History, Law, and Real Estate. I have over 10 years of experience in reimbursement. I have acted as a consultant for business start ups and have assisted in scaling established businesses. I am open to fixed rate jobs writing white papers, conducting research, and providing professional power point presentations. Samples are available upon request - with exclusion of all proprietary information. Additionally, I am open to long-term opportunities as a Reimbursement Specialist (rate: $25-35/hour - depending on work volume) Education: B.A. Humanities - University of Maryland, College Park J.D. (expected 2023) - University of the District of Columbia Law Skills: - White Papers - PowerPoints - CPT & CDT Coding - ICD-9 & ICD-10 - Writing & Proofreading - Healthcare Billing: Dental, Medical & Mental Health - Oral Radiology License (Maryland) - Real Estate License Recent Projects: 2023: White Paper Copywriter - healthcare, U.S. legal topics, B2B, SaaS 2020-2022: Appeals Specialist 2018-2020: Business Consultant Accomplishments: 2017: Grant Acquisition for dental clinic exceeding $80K over 3 years. Implemented EMR for a dental clinic. Through established guidelines, my client was able to successfully re-attest for continual grant funding (only clinic that received this type of funding in the state) 2018: Billed and collected for insurance claims submitted on behalf of four FQHC with production totaling over $1M per month. Averaged 200+ medical claims per day. Identified trends of payment / non-payment from insurance carriers to resolve issues and secure maximum reimbursement. 2019: Drafted white papers for clients in the healthcare reimbursement industry. Established reimbursement infrastructure for VC Medical Start-Up. Streamlined lead generation. Developed an efficient appeals process. Assisted with CLIA accreditation and CPT development. Developed reimbursement strategies for new treatment targeting adolescent developmental disorders. Performed code analysis for application for new medical code inclusive of treatment. 2020: Established telehealth infrastructure for Medical Cannabis company. Managed recruitment, screening, and job placement for healthcare company. Passed EHR audit for company's Meaningful Use. Completed multi-panel credentialing for mental health providers. 2020-2023: Oversaw senior level management of a corporation resulting in $100k+ increase in revenue per year. Able to scale businesses successfully and provide marketing resources (web design, blog writing, client resources etc.)
    vsuc_fltilesrefresh_TrophyIcon Medical Billing and Coding
    File Management
    Email Communication
    Google Workspace
    Medical Billing & Coding
    Dental Technology
    Data Entry
    Providing Information to Callers
    Medical
    Phone Communication
    English
    Virtual Assistance
    Customer Support Plugin
  • $25 hourly
    I am a Certified Billing and Coding Specialist (CBCS). I have been handling the billing and coding of a fast-paced medical office for almost 13 years. I also taught classes on Medical Office Management/Billing and Coding online during the Covid shut down. I have performed all of the scheduling, patient data entry, collections, ICD-10 Billing, CPT and HCPCS coding, A/R, insurance denials, and all aspects of what is necessary to run a successful medical office. I am very effective in supervising office support and medical staff, maintaining electronic health records and billing systems, and coordinating financial and budgeting activities. I set up all of the aging reports in NexGen and monitored them as necessary. I feel that I care greatly about the patients that I am working with and I always try to be respectful and empathetic no matter what I am tasked to do. I love the work that I do and I am very passionate about continuing to learn more and more about the industry. Oh, and I am proficient in all Microsoft Office Suite applications as well as NextGen Medical Office Software.
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    Order Processing
    Administrative Support
    Word Processors & Desktop Publishing Software
    Payment Processing
    Office Administration
    Medical Billing & Coding
    Microsoft Excel
    Data Entry
    Accuracy Verification
  • $40 hourly
    I currently own and manage an 8-client billing company. We take care of everything from benefit verification, posting charges and payments to sending patient statements and credentialing. We like to follow-up with insurance companies on a bi-weekly basis and strive to do our best in any situation. Other duties have included marketing, employee training, reporting, HIPAA training, collections and court proceedings, as well as provider credentialing, Privacy Policy development, marketing, and website creation. I am a member of the Michigan Medical Billers Association and the American Medical Billing Association. In the course of my billing career, I have performed various duties such as HCPCS research, fee investigation for similar providers, as well as development of procedure manuals and business form creation. We have worked in many specialties including Optometry, Behavioral Health, Chiropractic, Physical/Occupational/Speech Therapy, Massage Therapy and Non-Emergency Medical Transportation. We are experienced in all MS programs, as well as Quadax, Gateway, VisionWeb, Emdeon (Change), Quickbooks, many billing software programs and EMR systems. We are also well-versed with insurance websites and several different PMS systems, such as Compulink, OfficeMate, Kareo, eThomas, Crystal PM, Practice Mate, ChiroFusion, PracticeEHR and Practice Suite to name a few.
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    Customer Service
    Medical Billing & Coding
  • $50 hourly
    I have been involved in the medical field for over 15 years. I have an Associates degree in Health Information Technology with concentration on Medical Billing and Coding. I can pick up new software rather quickly. I am very detailed oriented. Also I am very passionate about the work I do in the medical field. It is very rewarding and stimulating. I am looking for project/clean up work that I can complete on the side as I do have a full time day job. I enjoy digging in and researching issues to find resolve and improving work flows. I look forward to meeting and working with new companies and people.
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    Virtual Assistance
    ICD Coding
    Light Bookkeeping
    Insurance Verification
    Accounts Receivable
    Medical Billing & Coding
    EMR Data Entry
    Microsoft Access
  • $22 hourly
    ~Available to start Today~ SKILLS: PDF Mail Merge, Convert PDF to Excel, Spreadsheets, Excel, Data Entry, Word, Google Sheets, Customer Service, Accounts Receivable, Website Design, Certified Medical Coder, EXPERIENCE: 15+ years in Data Entry, Data Mitigation, Data Conversion, Excel, Customer Service, Accounts Receivable, Quality Control, and MS Office. 10+ years in Medical Billing, Insurance, Coding and Auditing I currently work as an Administrator for a small company in the United States. My daily task include anything to be done in an office setting not limited to but including: customer service, answering emails, data entry, excel and MS word. I have 10 years experience in the medical field doing Billing, Insurance and Coding. I am HIPAA compliant and currently Certified as a Certified Coding Specialist. I received my Diploma from Medvance Institute of Baton Rouge in 2007 where i graduated with a 4.0 GPA. I manage stress by prioritizing my responsibilities so I have a clear idea of what needs to be done when, has helped me effectively manage pressure on the job.
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    Medical Billing & Coding
    Invoicing
    PDF Conversion
    Electronic Medical Record
    HIPAA
    Data Collection
    PDF
    Administrative Support
    Customer Service
    Accuracy Verification
    Google Docs
    Medical Records Software
    Data Entry
    Microsoft Word
    Microsoft Excel
  • $25 hourly
    Need an experienced Medical Biller/Coder? Have a backlog of claims that needs processing before timely filing? Not sure how to fill out a claim form? Have questions about billing tele health? Have records request? I am a 34 year old (AAPC) Certified Professional coder with over 6 years experienced in coding and over 10 years in the billing and insurance industry. I have worked in many specialties, such as OB/GYN, Family Medicine, Internal Medicine, Hospitalist coding, Hospital billing, denials, rejections and other billing related tasks. My background is listed below with a more detailed information: ✅Experienced Medical Coder/Biller with a demonstrated history of working in the major hospital systems and insurance industry. ✅Experienced with ICD-10, HCPCS, and coding related tasks along with denials/rejection of edits experience. ✅Auditing and reviewing medical documentation for appropriate ICD and CPT coding and documentation ✅Able to identify trends within a workflow that is causing an influx of edits. ✅Worked on backlogs for clients and have completed them by the deadline given ✅Skilled in Microsoft Excel, Customer Service, Insurance, Business Analysis, and Leadership. ✅ Strong healthcare services professional with a Associate’s Degree focused in Business Administration and Management, General from South University. Systems: ✅ EPIC ✅Cerner ✅Allscripts ✅Meditech
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    Email Communication
    Medical Procedure Coding
    Microsoft Excel
    Customer Support
    Medical Mastermind Medical Billing Services
    Customer Service
    Accuracy Verification
    Medical Records Research
    Medical Billing & Coding
    Phone Communication
    Electronic Medical Record
    ICD Coding
    Medical Condition Coding
    Data Entry
    Epic Systems Medical Software
  • $10 hourly
    Detail-oriented Medical Billing/AR Specialist and QA Analyst with 9+ years of experience managing complete Medical Billing Revenue Cycle Management. I have diversified experience working on different provider specialties, EHR, and PM software for many clients with full satisfaction. Our expertise is listed below. • Patient Scheduling • Prior Eligibility • Prior/Retro Authorization • Charge Creation with Verifying LCD, NCCI, Coding, and Eligibility • Coding and Billing • Charges verification and Submission • Payment/Denial Posting • Patient Payment Posting • AR Follow-up and Denial Fixation • Creating and sending appeals (if required) • Quality Assurance of AR • Patient Statements • Audit and Consultation • Financial & RCM Reports Software and Applications Expertise - CureMD - AdvancedMD - eCW (Eclinicalworks) - Kareo - Practice Mate – Office Ally - Care Cloud - Athena - EPIC - Therapy Notes - Encoder Pro - Trizetto, Avality, Navinet & Emdeon Further, I have worked with Different clients and helped Medical Billing Companies as a Medical Biller, AR specialist, and Billing Supervisor. I have also experience communicating with US doctors and other third-party healthcare staff i.e. insurances, doctors, clearing houses, and other third-party payers. I am also specialized in Medical Billing QA with overall Financial & RCM Reports.
    vsuc_fltilesrefresh_TrophyIcon Medical Billing and Coding
    Accounts Receivable Management
    EMR Data Entry
    Medical Mastermind Medical Billing Services
    Revenue Management
    Healthcare Common Procedure Coding System
    Electronic Medical Record
    Medical Transcription
    Medical Terminology
    Medical Report
    Medical Procedure Coding
    Medical Records Software
    Medical Records Research
    Microsoft Excel
    Medical Billing & Coding
    ICD Coding
  • $40 hourly
    • I am a Practice Performance Consultant, Certified Registered Medical Coder, Radiology Tech, Medical Bill Review & Expert Witness Testimony for subrogated/denied claims for Arbitration & Dispute Resolution cases, I provide Reports, SIU Review, I am E&M update certified, completed Risk Adjustment HCC Coding Certification, completed Professional Compliance Officer Certification. I am current on updates, changes, additions and deletions of HCPCS, CPT, ICD10, and Modifier codes. • Detect and resolve coding, documentation, billing, compliance, RCM challenges, improve operations, optimize revenue. Client, provider, and staff education on optimizing defendable reimbursement and revenue with a focus on claims integrity and compliance. Create and maintain trusted relationships with client key operational staff and decision makers. Exceptional client support. Experience with In-House and Outsourced Billing in USA and Offshore. • Responsible for overseeing and participating in each component of life of claims, revenue cycle management, processes, work-flows, and documented SOP. • Full life claims management, corrective actions, follow-through to adjudication. RCM, prospective and retrospective coding and documentation audits, RCM quality analyst, false claims compliance and risk and loss mitigation, practice consulting.
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    Medical Procedure Coding
    Medical Mastermind Medical Billing Services
    Medical Condition Coding
    Medical Billing & Coding
    Medical Records Research
    Revenue Management
    Phone Communication
    Electronic Medical Record
    Medical Report
    Critical Thinking Skills
    English
    Medical Records Software
    Microsoft Office
  • $39 hourly
    Hi! My name is Amber Walker, MHA, CPC, CPC-I, and I have over 14 years of experience in the healthcare sector. Mission: My mission is to provide creative solutions for small and mid-sized behavioral healthcare organizations to facilitate strategic growth! Specialty: Mental and Behavioral Health I specialize in the following areas: - virtual assistance (authorization submission and benefits verification) - identifying gaps in workflows and drafting new workflows - resolving claim denials - identifying root causes of claim denials - insurance claim submission and follow-up (In Network, Out of Network, EAP, and Self-pay) - validating insurance payments underpayments and overpayments according to contractual agreements - drafting claim appeals - accounts receivable management - EHR integrations and set ups - credentialing and contracting Additional Experience - I've worked with commercial and government payers in GA, LA, CA, NJ, MD, IL, NY, TN, TX, FL, CO, OR, and VA. - I've used various EHR and EMR software such as Epic, ShareNote, PIMSY, Emdeon (Change Healthcare), Trizetto, Icanotes, Waystar, Optum, Kareo, Simple Practice, Charm, Athena, Therapy Notes, AdvancedMD, and Availity. - Google Suites, Outlook, Sharepoint, Access, Microsoft Excel/PowerPoint/Word, and OneDrive I look forward to discussing how we can strategically improve your revenue cycle and build a solid financial infrastructure. Respectfully yours, Amber Walker, MHA, CPC, CPC-I (Master of Health Care Administration, Bachelor of Biological Sciences, Certified Professional Coder (CPC) and Instructor (CPC-I))
    vsuc_fltilesrefresh_TrophyIcon Medical Billing and Coding
    Invoicing
    Healthcare
    Accounts Receivable
    Virtual Assistance
    Insurance Verification
    Insurance Consulting
    Insurance Claim Submission
    Healthcare Software
    Revenue Cycle Management
    Medical Billing
    Medical Procedure Coding
    Medical Billing & Coding
    Medical Mastermind Medical Billing Services
    Revenue Management
    Healthcare Management
  • $27 hourly
    I have extensive experience in medical billing (over 10+ years using various different systems) and have an associates degree in health care administration. I am friendly, loyal, and dedicate, individual who has an ambition to succeed in any given environment. I am an avid and quick learner, and am always up to a challenge whatever the situation. I get along well with others, self motivated and work efficiently on my own. I strong believe in good communication between freelancer and client, therefore we are always on the same page. I can a NDA to safeguard your data and also done HIPAA certification. I have my own phone line and fax line, which is HIPAA regulated for patient confidentially. My knowledge of CPT / ICD 10 Codes are up to date. My many years in the filed, i have the opportunity the learn the following, but not limited to: 1. Medical billing for several practice, which included posting charges, payments, ( reading EOB), working denials, F/U, very comfortable interacting with insurances and understanding exactly what needs to be done with denials/ re submissions. 2. Referral Corrdinator/ Medication Authorization: Referral and obatin authorization for patient. Performing authorization for studies ( MRI, MRA, CT, US, HIDA etc.) as well as medication authorizations. 1.Demographics Entry (a) Insurance Eligibility and verification of patient’s health benefits from insurance carrier’s website and through Phone. (b) Create appointments on scheduler while receiving patient calls 4.Claim Submission(Primary & Secondary Insurance) 5.Rejection Reports 6.Basic coding 7.Authorization 8.Account Receivable (a)Accounts receivable analysis with corrective and preventive actions and decision making for Collections. (b)- 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, Tricare etc...) 9. Patient Calling With work experience on the following PMS and EMR Software 1.Office Ally 2. Theranest 3. Medisoft 4. SRS 5. Acculea Caputre Clearing House: 1. Officeally Office Specialties: Internal Medicine, Family Practice, Pain Management, Chiropractic, Psychiatrist, home health, Labs, Hospital etc. Thank you much for taking the time.. to review my profile.
    vsuc_fltilesrefresh_TrophyIcon Medical Billing and Coding
    Accounts Payable Management
    Accounts Receivable Management
    Healthcare Common Procedure Coding System
    Electronic Medical Record
    Data Entry
    Medical Terminology
    Customer Service
    Medical Billing & Coding
  • $16 hourly
    Ex -Education Officer for AAPC Local Chapter Pakistan Qualification: Pharm-D (Doctor of Pharmacy) CERTIFICATIONS ● CPC (Certified Professional Coder) ● CPMA (Certified Professional Medical Auditor) OFFERING SERVICES I can provide complete RCM services including but limited to. ● Appointment Scheduling ● Eligibility & Benefits Verification ● Medical Coding ● Demographic & Charge Entry ● Insurance claims submission ● Claim Rejection ● Payment & Posting ● Secondary Claims Submission ● Account Receivable or Denial Management ● Medical Appeals ● Refunds (Insurance and Patient) ● ICD-10, CPT mapping ● Medical Scribing ● Credentialing ● Emails, and calls handling ● Virtual Assistant ● Front Office Services PROFESSIONAL SUMMARY ● 10+ years of multispecialty experience in the field of medical billing & coding ● Credit of establishing coding department in multiple US based RCM companies ● Diversified experience of dealing in multiple specialties/settings including but limited to Urgent Cares, Emergency Rooms (Freestanding), Ambulatory Surgical Centres, Hospitals (Profee - Micro to Tertiary care) Laboratories (General + Pathology + Genetic Testing), Diagnostic Radiology, Skilled Nursing Facilities, Wound Care Centres and other solo practices. ● Highly energetic and goal-oriented professional with promising managerial, teaching and training skills. ● Self- motivated and skilled individual equipped with knowledge and experience of team developing, strong decision making, leading and controlling coding tasks of 150+ providers of different specialties. ● Certified Professional Coder and Certified Professional Medical Auditor from AAPC, with profound knowledge of ICD-10 CM, CPT, HCPCS and modifiers and utilizing them efficiently. ● Developed and managed a sole medical coding department at a US based healthcare billing and IT Company, being the very first of its kind and by far the biggest coding facility of the country. ● Experience of efficient management of backlogs and claims denial. SUCCESFUL PROJECTS AND ACHEIVEMENTS ● NCD and LCD based cross walk to validate claim for medical necessity. ● Successfully developed and implemented NCCI based RBS rules and Modifier cross walk for appropriation of claims to be submitted. ● Conducted Coding audit campaign efficiently, based on 2012 OIG work plan. ● Introduced prescription verification for Sure script certification. ● Coordinated with Web EHR, MTBC soft and android development team, in ICD-9 to ICD-10 mapping module resulting in best android app of the time. ● Actively involved in process automation and verification of MTBC EHR (client end) MTBC soft (operations). ● Efficaciously revamped MTBC EHR according to the requirements of Meaningful Use (MU1, MU2 and MU3) Certification. ● Effectively managed incorporation of updates and changes in medical coding annually or when required. CORE COMPETENCIES AS MEDICAL BILLER, CODER & AUDITOR ● Extensive knowledge of medical terminology human anatomy and physiology, diagnostics, and pharmacology across a broad range of medical practice areas. ● Experience of dealing in multiple specialties including anesthesia, radiology, pathology, internal medicine and surgery. ● Certified proficient and experienced in ICD-10 requirements and procedures ● Comprehensive knowledge and utilization of CPT and HCPCS coding ● Working knowledge of compliance regulations HIPAA and PHI requirements. ● Ability to efficiently manage claim denials ● Experienced and efficient in backlogs management. ● Complete understanding of Managed care contract ● Knowledge of MCO, Medicare, Medicaid and commercial insurances. ● Working experience of changing and fast-paced medical care environments. ● Detail-oriented and competent at reviewing records for accuracy, completeness and compliance with regulations. ● Expertise in Electronic Medical Record (EMR) software ● Medical Insurance Claims processing & denials ● EHR- All scripts, Next Gen, Cerner, Practice Fusion
    vsuc_fltilesrefresh_TrophyIcon Medical Billing and Coding
    EMR Data Entry
    Microsoft Excel
    Medical Billing & Coding
    Medical Mastermind Medical Billing Services
    Accounts Receivable
    ICD Coding
    Medical Condition Coding
    Electronic Medical Record
    Healthcare Common Procedure Coding System
    Accounts Receivable Management
    Medical Terminology
    Medical Procedure Coding
    Electronic Health Record
    Medical Transcription
  • $12 hourly
    I would like to put into practice my skills in Medical Billing, Customer support and also fully utilize my office experience, technical training, strong work ethic and dedication. I also have broad knowledge and experience in computer software and hardware. My background as a Billing specialist for both Medical and Dental Billing and college education made me proficient enough in MS Word, Excel and office essential tools. I have advanced written & verbal English skills that will be able to communicate concerns effectively to Customer, Patients and Insurance companies as I encounter countless task in my work on a daily basis. Listed Below are some of the summary of duties that I have on my experience: • Responsible for collecting, posting and managing account payments. • Responsible for submitting primary, secondary and tertiary claims to various insurance companies either electronically or by paper. • Responsible for checking & acquiring the eligibility & authorization of the patient to the insurance. • Responsible for identifying the primary, secondary & tertiary insurance of the patient. • Responsible for following up with the insurance companies in relates to Aging Report: payments, recoupments & denied claims. • Responsible for resolving denied claims and correcting them if possible on a timely manner. • Identifies and resolves questions from patients, clerical staff and insurance companies. • Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations. KEY SKILLS AND QUALIFICATIONS: • Quick thinker and able to learn quickly any kind of job or task (e.g. customer service, medical biller, technical-support specialist, back-office support) • Computer Literate-proficient in Microsoft Word, Powerpoint and Excel. • Critical-Thinking skills—can determine at a fast pace, any type of customer’s needs. • Compassion—helps people. Able to empathize to a customer’s needs and respond accordingly. • Attention to detail—Stick to proper procedures and apply them as prescribed. • Organizational skills—can face multiple queries, with different needs and knows how to prioritize. • Calm under pressure—face urgent, critical situations almost daily. Being able to function in the heat of emergency. • Communication skills—can respond and adjust appropriately to any type of customer. Able to teach what is required in an understandable and complete manner. • Values teamwork, but can also work with less supervision • Always strive for excellence and for the continued growth of self, the team and the company With my skills, knowledge, and experience, I believe I can be an excellent asset to any growing company.
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    Medical Billing & Coding
    Accounts Receivable Management
    Electronic Medical Record
    Email Support
  • $10 hourly
    Specific Skill Sets: Dental Insurance Verifier / Account Receivable Agent / Customer Service Overview: Chantel is an expert Insurance Verifier for Dental Practices all over the US. She has a good knowledge of the entire RCM process, quickly learns practice management software, and has undergone HIPAA training. She also keeps herself updated with the changing trends in the Healthcare industry. KNOWLEDGEABLE ON THE FOLLOWING TOOLS: Practice Management Software -Dentrix -Eaglesoft -Open Dental -Carestack -The Digital Office Other TOOLS: -Slack -Splashtop -Dialpad -Perimeter81 Chantel also has more than 7years of experience in Customer Service and is a Process Trainer working with Hartford Insurance and Cigna Dental. She was trained in one of the Top BPO companies in the Philippines. FREELANCE HISTORY & ACHIEVEMENTS: Update as of 2021: Front Desk support for Daytona Pediatric Dentistry. Worked as a Dental Insurance Verifier and Account Receivable Specialist. Also promoted as a Dental Verification Team Leader managing 10 agents and working with 15-18 dental practices across the US. Verified 20-30 policies a day. This includes the Full Breakdown of the Benefits together with the patient's history. Resolved 20-30 outstanding claims in a Day. Chantel would like to thank you for reading her profile and for your time. She hopes you have a great day ahead of you.
    vsuc_fltilesrefresh_TrophyIcon Medical Billing and Coding
    Administrative Support
    Medical Billing & Coding
    Dental Technology
    Accuracy Verification
    Providing Information to Callers
    Email Communication
    Customer Experience
    Customer Engagement
    Life Insurance
    Customer Support
    Healthcare & Medical
    Insurance Coverage Analysis
    Customer Service
    Data Entry
  • $20 hourly
    A registered nurse in the Philippines with 5 years work experience as a medical transcriptionist and a certified coder both by AAPC and AHIMA, with 8 years experience in medical coding (ICD-9, ICD-10, CPT, PCS, HCPCS) specializing in various medical specialties such as Cardiothoracic, OB and Gynecology, ENT, Gastroenterology and Evaluation and Management. EMR/EHR software used: - eClinicalWorks - Epic - Citrix - Medgen - Practice Fusion Coding Tools used: - Optum CAC - 3M
    vsuc_fltilesrefresh_TrophyIcon Medical Billing and Coding
    Data Labeling
    Data Annotation
    Data Entry
    ICD Coding
    Error Detection
    Medical Translation
    Medical Procedure Coding
    Medical Records Software
    Medical Billing & Coding
    Medical Transcription
    Batch Proof Reports
    Data Migration
    Healthcare Common Procedure Coding System
    Accuracy Verification
  • $15 hourly
    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)
    vsuc_fltilesrefresh_TrophyIcon Medical Billing and Coding
    Payment Processing
    Financial Audit
    Medical Billing & Coding
    Medical Mastermind Medical Billing Services
    Accounts Receivable Management
    Marketing Management
    Medical Procedure Coding
    ChiroTouch
    Ehealth
    Medical Condition Coding
    Medical Transcription
    Revenue Management
    ICD Coding
  • $15 hourly
    I am a Medical & Home health billing professional with eight years of experience working with different healthcare providers from the US. Client satisfaction is always been my top priority. ✅ WHAT I CAN DO: - Revenue Cycle Management - Quality Assurance - OASIS Review - Strategy Formulation - EMR/EHR integrations - Credentialing/Contracting/Enrollments - Medical Records Management & Medical Records Sorting. - Medical Billing and Coding - Homecare & Hospice Billing/Coding - Patient registration & scheduling. - Caregivers Recruitment - Charge entry. - Eligibility and benefits verifications. - Claims Submission. - Denials management. - Insurance follow-ups. - Account Receivables - Payments posting. - Patient calling. - Appeals. - Medical records management. - Prior authorizations. - Handling patient/insurance/attorney calls - Monthly and annual reports preparation MEDICAL CODING Medicaid, Medicare, Veterans Affairs, Commercial payers, Military payers, HMOs/PPOs. - ICD10 Coding - CPT and HCPCS Coding - Use of Modifiers BILLING SOFTWARE EXPERTISE - Practice EHR - Advance MD - CureMD - LIS Lab Billing software - eClinicalWorks - MD Vision - SequelMed - AXXESS Home Health - Axis Care - Matrix Care - Alora Home Health - AXXESS Hospice CREDENTIALING Strategic Operational Planning & Execution; Team building & Leadership; Quality & Safety Assurance (QS/SA); Production Solutions Analysis & Implementation; Six Sigma & Lean Analysis, Evaluation & Troubleshooting
    vsuc_fltilesrefresh_TrophyIcon Medical Billing and Coding
    Business Development
    Payment Processing
    Electronic Medical Record
    Medical Report
    Insurance Verification
    Process Integration
    Revenue Management
    QA Management
    Medical Editing
    Medical Billing & Coding
    Quality Assurance
    Medical Records Research
    Client Management
    Microsoft Excel
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At A Glance: Medical Billing & Coding

The healthcare industry is one of the largest and fastest-growing in the world. Healthcare services are being provided to an ever increasing number of people through social programs and health insurance providers. These programs interact with doctors, clinics, and other healthcare providers to help pay for or subsidize the costs of patient procedures. Such procedures can involve dozens of people, from insurance agents to hospital administrators, and can intersect with many different local and national laws.To help manage and organize all this information, a system of codes has been developed to organize and abstract all the procedures a patient can receive so insurance agents and patients know what they’re being charged for, and other medical professionals can proceed with billing and collections on those services. A medical billing and coding specialist is a vital part of the healthcare business if you’re performing any complex health services.

A medical coding specialist is a healthcare professional with experience and knowledge regarding the different medical code standards, such as CPT, ICD-9, and HCPCS, which help categorize and price medical procedures. Procedures that range from eye examinations to heart surgery are pulled from transcribed medical records, coded, and sent to a medical billing expert. Although medical coding and medical billing are different tasks, they can often be carried out by the same person, especially in smaller healthcare environments. A medical billing specialist is responsible for organizing the coded procedures and billing the various parties correctly. Together, a medical billing and coding pro is primarily responsible for making sure your business and operation can smoothly handle all financial accounts.

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