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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

As a skilled medical billing individual with extensive experience. Proud my-self on contributing to the provision of quality healthcare by working to obtain payments and reimbursements in a timely manner. Having a strategic and a broader understanding of the areas outside of billing and collections is important. Getting the bill out and collecting it are critical, but so are having the analytics in place to ensure you are collecting what you're supposed to collect, making sure contracts are paid at the level they're supposed to be paid, and ensuring that coding is accurate so it won't be denied later. In addition to being highly organized, work well with others. Duties have included communicating with insurance company representatives about potentially problematic claims and working out solutions with providers, insurers, and patients. Also worked with patients to create payment plans for the portions of their bills that are not covered by insurance. ICD-10, CPT-10, & Medical Terminology Specialty in Eligibility and Benefits Verification PRE-AUTHORIZATION Medical Insurance Credentialing Various Practice Management Software Claim Entry & Payment Posting Denial Management & Appeals Records Organization & Management Insurance & Patient Aging HIPAA Compliance Online Claim Submission

I am a HIPAA-Certified Medical Biller, Medical Virtual Assistant, and Revenue Cycle Management (RCM) Consultant with 15+ years of professional experience supporting U.S. healthcare providers. I specialize in Mental Health, Psychiatry, and Behavioral Health billing, helping practices streamline their revenue cycle, reduce claim denials, and improve cash flow. Throughout my career, I have supported private practices, group practices, hospitals, laboratories, and telehealth providers, managing the complete medical billing lifecycle from patient registration to final reimbursement. I have also worked as a Senior Operations Manager, leading teams of 200+ medical billing professionals, overseeing operational workflows, quality control, and revenue performance. I hold CPB (Certified Professional Biller) and CPC (Certified Professional Coder) certifications and have completed Medicare educational programs related to HIPAA EDI Standards and Medicare Fraud & Abuse compliance. My goal is to help healthcare providers focus on patient care while I handle the complexity of billing, compliance, and revenue optimization. Medical Billing Specialties I have extensive experience providing billing services with a strong focus on Mental Health, Psychiatry, and Behavioral Health practices, including individual therapists, group practices, psychiatrists, psychologists, and telehealth providers. • Mental Health / Behavioral Health Billing • Psychiatry & Psychology Billing • Therapy Practice Billing (Individual, Group, Family Therapy) • Telehealth & Telepsychiatry Billing • Outpatient & Inpatient Practices • Independent Laboratories • Home Health & DME Billing • Telemedicine Services This includes billing for services such as psychiatric evaluations, medication management, individual therapy, group therapy, behavioral health assessments, and ongoing treatment services, while ensuring HIPAA compliance and payer guideline adherence. Specialties Supported Sleep Medicine • Internal Medicine • Family Practice • Radiology • Cardiology • Ophthalmology • Dermatology • Gynecology • Urology • Rheumatology • Physical Therapy • Neurology • Pain Management • Psychiatry • Pediatrics • Podiatry • Psychology • Gastroenterology • Urgent Care • Mental & Behavioral Health • Pathology • Phlebotomy • CPAP & BiPAP Billing • Nurse Practitioners (NP / ANP) • Physical Therapy (PT) • Occupational Therapy (OT) • Speech Therapy (ST) • COVID Billing Insurance & Payer Experience Extensive experience working with major U.S. insurance payers including: Medicare • Medicaid • BCBS • UnitedHealthcare • Aetna • Cigna • Humana • Workers’ Compensation and multiple commercial insurance plans. I have handled billing operations for providers across many U.S. states including: Alaska • Arizona • Colorado • Connecticut • Idaho • Iowa • Maryland • Massachusetts • Minnesota • Montana • New Mexico • Vermont • Washington • Alabama • Illinois • Indiana • Kentucky • New Jersey • New York • Ohio • California • Florida • Georgia • Michigan • Missouri • North Carolina • Oklahoma Core Skills • End-to-End Revenue Cycle Management (RCM) • Insurance Verification & Eligibility Checks • Medical Coding (ICD-10, CPT, HCPCS) • Claim Creation & Submission (CMS-1500 / UB-04) • Denial & Rejection Management • Accounts Receivable (AR) Follow-ups • Insurance Calls & Claim Resolution • Payment Posting (ERA / EOB) • Medical Documentation Review • Provider Credentialing & Insurance Enrollment • HIPAA Compliance & Billing Audits • Financial Reconciliation (Daily / Weekly / Monthly / Quarterly) I perform efficiently in complex healthcare environments with minimal supervision, ensuring accuracy, compliance, and timely reimbursements. EHR / Billing Software Experience SimplePractice • AdvancedMD • Kareo • OfficeAlly • Docutap • Athenahealth • Therabill • eClinicalWorks (ECW) • EZClaim • TheraNest • ClinixPM • eThomas • Intergy • TherapyNotes • Waiting Room Solutions • Zendesk • Xifin • Phicure • TriZetto • CareCloud • Brightree • CollaborateMD • iPatientCare • Medisoft • Healthnautica Services I Provide I offer complete Revenue Cycle Management services, including: • Provider Credentialing & Insurance Enrollment • Medical Coding & Charge Entry • Claim Scrubbing & Submission • Rejection & Denial Management • Appeals & Insurance Follow-ups • Accounts Receivable (AR) Management • Payment Posting & Financial Reconciliation • Patient Billing Support & Calls • Appointment Scheduling & Medical Virtual Assistance I work closely with healthcare providers to develop customized billing workflows tailored to their practice, ensuring faster reimbursements, reduced denial rates, and optimized revenue performance.

I am an enthusiastic and dedicated professional with extensive experience across all areas of Health Care / Medical Billing & Provider Credentialing – Revenue Cycle Management and collections management. An exceptional leader with potential management skills who is able to develop and motivate others to achieve targets and meeting the client’s requirements. I can demonstrate a strong ability to manage projects from conception through to successful completion. A proactive individual with a logical approach to challenges, I perform effectively even within a highly pressurized working environment. I am responsible for directing and coordinating the overall functions of the medical billing and coding office to ensure maximization of cash flow while improving patient, physician, and other customer relations. I have strong managerial, leadership, and business office skills, including critical thinking and the ability to produce and present detailed billing activity reports.  I have 16 Years of experience in Revenue Cycle Management in all parts of this domain.  Having experience of 6 years in Team handling, for Billing and Account Receivable and Patient Services.  Working as process leader to complete the transition of new clients and coordinating with onshore team to complete new clients Transition and Implementation. I also Participates in the development and implementation of operating policies and procedures.  Ensuring the Claims Relaying to payers from different Practice Management Tools smoothly and monitoring the rejection ratio from payer and clearing houses.  Having good exposure in understanding of EDI setups also worked on multiple software as Claims Remedy, Relay Health, Office Ally, Emdeon, Optum.  Analyzing billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues with the Billing and AR Team.  Ensuring the complete process followed by all teams as Payment Posting / Charges / Correspondence for different specialties and Account receivable.  Maintaining the SLAs for Team - Patient Services / Patient Statement client’s co-coordinating the collections to reduce the Patient AR.  Monitoring the Collections process to ensure the Collection of Patient AR in co-ordination with client for collections agencies.  Handling the client's with specialties as Radiology, lab Billing, Ophthalmology, Internal medicine, Ambulatory services, Gastroenterology, Physical Therapy, Surgery clients, Pediatric, Chiropractic.  Analyze trends impacting charges, coding, collection, and accounts receivable and take appropriate action to  Completing the Enrolment/Credentialing application on Paper, online for the Hospital providers and individual solo providers and sending to the payers via Fax, Email, Payer portal, by mail etc.  Verifying the applications, demographic update requests from the payer including Medicare/Medicaid direct and CMOs/Advantage Plans.  Creating & Managing the CAQH profile and doing the Re-attestation at every 90 days so provider profile is not expired.  Generating notification report to Providers/Account Managers (Administrators) about License, COI, Certification updates and expiration.  Working on Regular follow-up with Insurances about status of application in every 15 days to get the progress on the application.  Managing CMS revalidation/attestation for the providers.  Completing EDI Enrolment for the providers on the EDI platform.  Submitting Appeals for the Area/State where the panel is closed and provider is unable to get credentialed.  Creating credentials for the provider portal and submitting online application for faster processing.  Getting Approval letter, Effective date, provider id, plan types (credentialed with) and sharing with provider so they can start seeing patients and get reimbursed.

Hello, I’m Joginder Negi — a results-driven professional with 12+ years of expertise in Medical Billing, RCM, and Credentialing, along with strong technical skills in IT Infrastructure, Cybersecurity, and Cloud Support. This unique combination enables me to deliver comprehensive business and technical solutions tailored to healthcare practices and organizations worldwide. 🏥 Professional Medical Billing & RCM Specialist 12+ Years of Proven Experience in end-to-end Revenue Cycle Management. Managed successful billing for multiple specialties: OBGYN, Mental Health, Physical Therapy, Internal Medicine, and more. Expert in CPT & ICD-10 Coding, Denial Management, and Compliance (HIPAA, GDPR, SOC-2, ISO). Credentialing Specialist for Medicare, Medicaid, UHC, Cigna, Tricare, Availity, and commercial payers. Proficient with major PMS/EMR platforms: InSync, NextGen, Athena, eCW, Office Ally, AdvancedMD, and more. Achievements: Renowned for optimizing billing processes, reducing denials, and improving revenue flows. 💻 IT, Cloud & Security Support Professional Office 365, Google Cloud, and Infrastructure Support. Windows & Linux Server Administration with end-point protection expertise. Firewall & Network Security: Cisco, Palo Alto, Fortinet. Cybersecurity: SOC L1/L2/L3, VAPT, Security Audits, CISSP-aligned practices. Endpoint Security & EDR Tools: Trend Micro, McAfee, SentinelOne, CrowdStrike. Compliance: HIPAA, GDPR, SOC-2, ISO standards. Helpdesk & Support Operations: L1–L3 troubleshooting, enterprise support, and infrastructure optimization. 🔑 What Sets Me Apart 🎯 Versatility: Dual specialization in Healthcare Billing/RCM and IT/Security Support. 📈 Proven Track Record: Success with practices, healthcare providers, and IT-driven organizations. 🔐 Compliance-Driven: Strong adherence to HIPAA, GDPR, SOC-2, and ISO guidelines. 🤝 Client-Focused: Collaborative, transparent, and solution-oriented approach. 🌍 Global Experience: Adaptable to diverse industries, systems, and regulatory environments. 🚀 Services I Offer Healthcare & Billing ✔ Comprehensive Medical Billing Services ✔ Efficient Claims Submission & Follow-Up ✔ Expert Credentialing & Enrollment Assistance ✔ Thorough Coding & Documentation Reviews ✔ Consulting Services to Optimize Revenue Cycle IT & Security ✔ Infrastructure & Cloud Support (Office 365, Google Cloud) ✔ Security Audits, VAPT, SOC Implementation ✔ Firewall & Endpoint Protection (Cisco, Palo Alto, Fortinet, CrowdStrike, etc.) ✔ Windows & Linux Server Administration ✔ Helpdesk Support (L1–L3) 🌐 Let’s Work Together Whether you need seamless medical billing & credentialing services or robust IT/security support, I bring a unique blend of expertise to help your organization thrive. 📩 Let’s connect and discuss how I can add value to your project!

►I have strong 10 years of Experience ►I am Certified Biller from AAPC ►HIPPA Certified ►Experienced in State worker compensation And No fault, And an expert in major TPA, MCO, HMO, PPO, POS AND INDEMNITY carriers, ►Experienced in Charge entry ►Payment posting ►Team Handling ►Denial Management ►Eligibility Verification ➨ Special Skills ►Submitting Meaning full use ►Credentialing and contracting ►Medicare & Medicaid Auditing ►Technical Medical Injury Writer (Narrative) ►In 10 years I have gained remarkable knowledge about obtaining payments from worker comp carriers. ►Well versed with Many EHR/EMR systems ►I am also expert in Obtaining payments from Government Carriers and other Carriers are very difficult to get in touch, it's really a challenge for a medical billing service to bring Payments. However, we have special knowledge to bring payment or Correspondence from Government carrier for Doctors within 45 Business days.