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Over 16 years of experience in the Medical Insurance Billing and Coding field. Knowledge of multiple EHR/EMR's (including E-Thomas, Epic, Greenway, Healthpac, NowMD, Athena, eCW etc). I am experienced in all aspects of the RCM, including collections, and credentialing. Specialties of provided services include but are not limited to Vein and Vascular Surgery, Wound Care, Internal/Family Medicine, Cardiology, Dermatology, Pulmonology, and Neurology. With the 16 years in the field also comes the knowledge of the billing guidelines and procedures for multiple insurances including Medicare, Medicaid, VA, BCBS, Aetna, Humana, all Medicare and Medicaid plans, auto and workers comp, along with a vast of other private and commercial insurances. I am also experienced with Facility/UB04 billing—Member of the AAPC, and Certified Coder. CPC. I am currently in the process of obtaining RCMS certification. I also have experience in Optimization and processes to help make your billing efficient as possible. I have experience with credentialing(CAQH and outside of that), as well as all enrollments such as cleaning houses, software setup, ERA/EFT connections which include SmartData and EDISS.

I am a Certified Professional Medical Coder and Auditor with extensive experience in professional fee coding, coding compliance, payer policy interpretation, and revenue cycle management across multiple physician specialties. I specialize in reviewing clinical documentation to ensure accurate CPT, ICD-10-CM, HCPCS, and modifier assignment while identifying coding opportunities, documentation gaps, compliance risks, and reimbursement issues. My expertise includes medical coding audits, coding validation, payer policy research, NCCI edits, MUEs, modifier application, denial analysis, documentation review, and revenue integrity. I have extensive experience working with Medicare, Medicaid, and commercial payers, applying CMS regulations and payer-specific guidelines to support accurate, compliant reimbursement. Whether reviewing operative reports, clinic documentation, or complex coding scenarios, my approach is always evidence-based, guideline-driven, and focused on delivering clear, defensible coding recommendations that help providers maximize compliant reimbursement while minimizing audit risk.

Capable of achieving personal objectives as demonstrated by my prior work experience and my commitment to leisure pursuits. Excellent communication skills and an ability to relate to all levels of commercial and social contacts. Extremely ambitious, goal oriented with a clear and concise vision of future objectives. Eager to find a position offering long term potential with a structured, defined career progression. • Coding and doctor office queries • Communicating with front desk and headquarter • Dealing with Rejections and Payer responses. • Working with Worker Compensations/No fault • Weekly meeting with both offices • Interview with the new staff • Team building • Learning the new implementation and rules. • Experience in Medicare/Medicaid Billing/Coding; Familiar with ICD-9 and/or (ICD-10) and CPT Coding, OASIS, and other accepted conventions associated with home care billing • Knowledge of health care coverage and benefits preferred • Submit claims to appropriate insurance agencies, timely and accurately. • Follow up to insure proper payment of claims. • Resolve denials and other issues which prevent claims from being paid. • Appeal denied, low reimbursed and rejected claims • Resubmit corrected claims for payment • Verify coverage for active patients • Contact patients to obtain updated insurance information • Retrieve Electronic Remittance Advice (ERA). • Oversee and streamline billing and collections processes • Coding for all the Specialists (Hospital & Clinics) • Month-end closing of the billing group information • Plan and implement quality assurance for all processes • Special program/billing planning and implementation • Personnel development; staff meetings • Staffing discussions and planning/interviews; Team building • Field Operators’ problem escalation and customer service • Assist with the implementation of a new billing system • Prepares and submits clean claims to various insurance companies either electronically or by paper. • Answers questions from patients, clerical staff and insurance companies. • Identifies and resolves patient billing complaints. • Prepares, reviews and sends patient statements • Evaluates patient’s financial status and establishes budget payment plans. Follow ups and reports status of delinquent accounts. • Reviews accounts for possible assignment and makes recommendations to the Billing Supervisor, also prepares information for the collection agency. • Performs daily backups on office computer system • Perform various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers. • Processes payments from insurance companies and prepares a daily deposit. • Participates in educational activities and attends monthly staff meetings. • Conduct self in accordance with HIPAA’s employee manual. • Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations • Working on Practice AR. • Downloading ERA’s from Capario portal. • Downloading ERA’s from BCBS Portal AHIN. • Claim Submission on Medicaid portal of Medicaid of Arkansas Check the Daily received work on FTP server. • Distribute the work among my team members. • Coordinate practice management related issues with off shore providers/Doctors. • Provide on the Job Training to the whole Billing Team. • Perform acute Follow-up on daily work entered and on outstanding claims. • Make phone calls to different insurance companies for outstanding claims resolution. • Prepare monthly/weekly analysis reports for the associated practice. • Inform the superiors about any flaws appearing in the processes. • Responsible for Client monthly collection • Work on Client Queries • Co-ordination with Account receivable Department • Co-ordination with Client Services Department • Work on client Queries • Work on Patient Queries • Quality assurance of Daily Production

Motivated medical billing and coding specialist with an array of experience in health operations management, billing, and coding. Expertise in ICD-ICD-10 CM/PCS and CPT. Highly skilled in analyzing and validating patient information, diagnoses, and billing data. Demonstrated leadership skills that enable the processing of high volumes of patient information to achieve revenue generation goals.

Certified medical coder partnering with provider organizations to optimize outcomes by - Outsourced medical coding and medical billing (CIRCC, I/P, O/P, PHP, ASC, HH, SNF, CC, ED, Imaging, Cath Lab, Interventional Cardiology) - Credentialing with Medicare, Medicaid and Commercial payers (including delegated groups) - Performance measures documentation - Streamlining practice workflows - Engaging stakeholders through education - Providing feedback via periodic chart audits - Re-engineering templates through CDI - Reimbursement analysis to identify gaps - Development of periodic executive level reports - Reports generation for presentation to Board - Revenue Cycle Improvements - Electronic health record template creation / updates - Compliance program - Staff training, development and mentoring - Cost reporting file support - wRVU reporting - Data analysis - Charge master Analysis of your productivity and customization of reporting from your system. Certifications: CCS, CCS-P, CIRCC, CDEO, CMARS, CICA, CPC-I, CPC Datasets: CPT-4, ICD-10-CM, ICD-10-PCS, ICD-9-CM, HCPCS Level II, RXNORM, NDC, LOINC, SNOMED CT, HL7, HSLOC, ICF, CVX, IS-A, HCPCS Level III, SDOH SYSTEMS: EPIC, CPSI, 3M, HBO, GE patient management systems IDX and GPMS, Allscripts/Touchworks, TES, Ingenix Claims Manager, Medinformatix, Meditech, eClinicalWorks, NextGen, Athena, Charm, AdvancedMD, SMS Signature, Cycare, BCA, OXFORD, MEDCAT, PM2000, Medical Manager, Mestamed, Medisoft, RIMS, NICE, HCPS, CSS, Dairyland, OfficeAlly, ClearCare. Web-page experience: HTML 5.0, CSS, Python, Microsoft FrontPage, Visio. Rate negotiable based on the project.

With over 6 years of hands-on experience in medical billing and coding, I specialize in optimizing revenue cycle management for healthcare providers. I ensure precise coding, prompt claim submissions, and maximized reimbursements all while maintaining strict HIPAA compliance and staying current with evolving industry standards. Whether you're a solo provider, a multi-specialty clinic, or a large healthcare facility, I deliver customized solutions designed to boost your financial outcomes and minimize claim denials. My Services Include: ✅ Medical Coding: Proficient in ICD-10, CPT, and HCPCS across a wide range of specialties ✅ Billing & Claims Submission: Accurate and timely submissions to ensure maximum reimbursement ✅ Revenue Cycle Management: Comprehensive solutions from patient intake to payment posting ✅ Denial Management: Analyze, correct, and prevent claim denials to improve cash flow ✅ Insurance Verification: Confirm eligibility and benefits upfront for smoother billing ✅ Audit & Compliance: Thorough reviews to ensure coding and billing meet regulatory standards Tools & Platforms I Use: 💻 Billing Systems: Athenahealth, Cerner, Epic, Kareo, AdvancedMD, NextGen, eClinicalWorks 💻 Coding Software: Optum360 Encoder Pro, 3M CodeFinder 💻 Payer Portals: Aetna, UnitedHealthcare, Medicare, Medicaid Why Work With Me? 🩺 Certified Professional with a strong foundation in medical billing and pharmacy ⏱️ Detail-Oriented: Proven ability to reduce errors and streamline workflows 📈 Results-Focused: Helped clients increase reimbursement rates and decrease claim rejections 🤝 Client-Centered: Dependable, responsive, and committed to excellence Let’s Connect: Looking to improve your billing and coding processes? Let me handle the complexities so you can focus on what matters most patient care. Contact me today to get started!