Greeting,
Certified HIPAA professional and Certified professional biller from AAPC and working in the medical billing Industry since 2014. I have 9 years of diversified experience dealing in multiple specialties/settings including but limited to Urgent Cares, Emergency Rooms (Freestanding), Ambulatory Surgical Centers, Hospitals (Profane - Micro to Tertiary care) Laboratories (General + Pathology + Genetic Testing), Diagnostic Radiology, Skilled Nursing Facilities, Wound Care Centers and other solo practices.
CERTIFICATIONS: -
1. CPB (Certified Professional Biller)- AAPC
2. CPC (Certified professional coder)- AAPC
3. CCS- AIHMA
4. HIPAA Certification
5. Advance Excel and pivot
Skill Set and core Expert Area:-
-Account Receivable specialist
-Medical research writer, QA, and Regulatory pharmacist,
• Patient demographic entry
• Charge Entry in billing software
• Eligibility verification with payers
• Medical claim scrubbing.
• Claim submission to payers
• Primary, Secondary and tertiary payers claim to process.
• Denial Management, Emails, and calls handling
* Insurance and eligibility verification
• Account Receivable follow up
• Payment posting and adjustment management
• Patient billing for patient’s responsibility
• Customized financial reports.
• Scheduling calendar
I have a working knowledge of compliance regulations HIPAA and PHI requirements, as well as have a complete understanding of Managed care contracts, MCO, Medicare, Medicaid, and other commercial insurances.
Furthermore, I have complete knowledge and expertise in Electronic Medical Record (EMR) software, Optum 360 Encoder, Citrix & RDP’s, Next Gen, Cerner, Practice Fusion, Ms. Office, Ms. Excel, ECW, JANEAPP, ADVANCEMD, DENTRIX, OPENDENTAL, CRITERION, THERANEST, SIMPLE PRACTICE, OFFICEALLY, AVAILITY and many others
Medical Billing :
I have Medical Billing experience for almost eight years. During these 8 years, i have worked on many specialties. I do know the complete RCM flow, i have been doing charge entry, payments posting, and AR follow-up.
Have worked as Team Leader in different organizations. I have a working knowledge of Charge entry, claims submission, working on rejections, Benefits verification, ERAs/EOBs posting, Insurance Call for doing a follow-up on unpaid claims/denial management, and getting referral information using different resources. In addition to these, i can also handle patient calls; by this provider, the office can focus more on their patients' care.
Expertise:
#Account receivables, #Collection management , #Outpatient and inpatient Billing, #ICD-10-PCS, #ICD-10-CM, #HCPCS, #CDT, #CPT, #ICD-10-AM
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
- Superbill review
- Appeals
(c). Specialties
Anesthesiology
Cardiology
Chiropractic
Dermatology
Emergency Medicine
Endocrinology
Family Practice
Gastroenterology
General surgery
Geriatrics
Gynecology and obstetrics
Internal Medicine
Pneumology
Orthopedic
Otolaryngology
Pathology
Pediatrics
Physical Medicine and Rehabilitation
Physical Therapist
Psychiatry
Neurology
Radiology
Radiotherapy
Rheumatology
Urology
Practice Fusion
