Thank you! For visiting my profile. To work as a Medical Billing Project Manager or in another Healthcare position which, fully utilizes my skills and experience while offering an opportunity for advancement. I have worked 6.5 years in a US-based company. (Over all I have medical billing experience of 9.5 years.) From a Medical billing specialist, AR to Management level had almost performed all the tasks related to Medical billing. As Assistant Manager Operations I lead the group of 150+ employees and look after all of their administrative and operational tasks. As a Management Coordinator and a Strategic Analyst I have worked on Company top priority projects. I have worked on highest priority projects and acquisitions assigned by company. 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. I have worked with Preffered MD for two years as covid -19 biller and AR specialist. 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, ICD10, 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 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 Dental billing

Welcome to my profile! Medical billing is my passion. I help healthcare providers, from independent doctors to large practices, maximize their revenue by ensuring accurate and timely billing and credentialing. With over 10 years of experience, I specialize in streamlining the Revenue Cycle Management (RCM) process, reducing claim denials, and ensuring compliance with all relevant regulations. I’ve helped clients in a range of specialties to optimize their revenue cycle and reduce errors in their billing. I am committed to getting your practice the reimbursement it deserves. My experience encompasses a wide array of specialties, including: - Facility Billing (UB04) - Internal Medicine - Pain Management and Rehab Medicine - Cardiology/ Cardio-vascular - Nephrology - Podiatry - Hospitalist - Behavioral Health - Anesthesia - OBGYN - SNF - Home Health My comprehensive expertise extends to various EMR/EHR/PM software, including: - eCW - HHA Exchange - Practice Fusion - Inovalon - Advanced MD - Athena - TRAKnet - Simple Practice - NextGEN - Kareo - Medisoft - Aprima - Dr. Chrono - Office Ally - Therapy Notes I pride myself on my strong communication skills, which ensure clear and timely updates throughout every project. My commitment to delivering high-quality, compliant billing services means your practice will receive accurate reimbursements and minimize claim denials. Whether it’s streamlining your billing process or ensuring regulatory compliance, I am dedicated to driving results that improve your practice’s bottom line.

Motivated medical billing and coding specialist with over 8 years of experience in health operations management, billing, and coding. Expertise in ICD-9 and ICD-10, CPT, and HCPCS coding. 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. EXPERIENCE: MEDICAL BILLING & REIMBURSEMENT SPECIALIST • Responsible for processing payments, adjustments, and denials according to established guidelines (Payment Poster) • Knowledge of HCFA 1500 and UB4 1450 form. • Responsible for submitting electronic claims and paper claims to primary, secondary, and third-party insurance companies. • Knowledge with prior authorizations and cash posting. Able to read and interpret EOB's. • Review medical record documentation to identify services provided by physicians and mid-level providers as it pertains to claims that are being filed. • Ensure accurate entry of work into designated billing systems. • Assist with training materials and training staff members. • Communicates with the Clinics to provide or obtain corrected or additional data. • Performs corrections for patient registration information that includes, but is not limited to, patient demographics and insurance information. • Responsible for working EDI claim rejections in a timely manner. • Prepare and submit billing data and medical claims to insurance companies. • Collect and review referrals and pre-authorizations. • Follow up on missed payments and resolve financial discrepancies. • Investigate and appeal denied claims. • Register patients in the EHR system • Work with insurance companies to handle any "problem" claims that have trouble getting paid. • Send inpatient and outpatient claims to insurance companies for our clients with an emphasis on accuracy in coding. • Many various activities that included data entry, verifying insurances, follow-up, authorizations, and many more. Familiar with Softwares: I’m good at using different Billing cloud base software’s: • Advanced MD. • Office Ally. • CareCloud • Crystal PM • WayStar • Simple Practice • Drchrono • Collaborate MD. • ECW (E-clinical Works). • Athena Net • Care Tracker • Icanotes • Kareo • Medisoft • Emdeon EHR/EMR system • EPM (Electronic Practice Management). I have worked on following Billing specialties: • Internal Medicine. • Family Medicine. • Chiropractic • Gastroenterology. • Cardiology. • Radiology. • Oncology. • Ophthalmology. • Acupuncture etc. • Physical Therapy. • Mental Health. I have also experience communicating with US doctors and other third-party healthcare staff i.e. insurances, doctors, clearinghouses, and other third-party payers. Credentialing With insurance for All Payers. I have good experience for the credential of the provider with insurance for Medicare, Medicaid, And Commercial Payers. KEY SKILLS: • Ability to calculate figures and compute rate, ratio, and percent and to draw and interpret bar graphs and the ability to apply basic algebraic concepts. • Ability to work quickly. • Ability to read an explanation of benefits (EOB) and assigned patient liability including secondary/tertiary assignments. • Ability to read accounts receivable. • Knowledgeable in personal computer software and general office procedures. • Knowledge of Accounts Receivable. • Strong knowledge of medical terminology. • Excellent verbal and written communication skills, including the ability to effectively communicate with internal and external customers. • Knowledge and experience with Hospital & Professional Billing. • Medicare part A billing experience included Medicare DDE system. • Sound knowledge of EOB and ERA. • Working knowledge of basic computer functions, with an emphasis on typing. • Knowledge of Medicare/Medicaid billing (UB4). • HCFA 1500 • Denial Management. • Hospital Billing • Home Health Billing/Medicare Part A billing. • Office Billing • Strong teamwork skills • Critical thinking and problem-solving abilities.

Highly experienced healthcare professional with over 20 years in the US medical billing industry. Proven ability to manage large teams, lead strategic projects, and drive financial performance. Expertise in all aspects of medical billing, coding, and revenue cycle management. Seeking a Medical Billing Project Manager or similar leadership role offering opportunities for advancement. Experience Management Roles: Manager Operations (leading 120 employees), Manager Special Projects, Manager CPI, and Strategic Analyst. Strategic Leadership: Developed business and strategic plans, managed high-priority projects and acquisitions, contributed to marketing strategies. Financial Acumen: Conducted financial analysis for various projects. Communication & Collaboration: Extensive experience communicating with US doctors, insurance companies, clearinghouses, and other healthcare stakeholders. Process Improvement: Visited US doctors’ offices and hospitals to gain in-depth knowledge of their processes and identify areas for improvement. Medical Billing Services Expertise - Eligibility verification (online and via phone) - Appointment scheduling - Patient demographics and charge entry - Claims submission (primary, secondary, and tertiary) - Accounts receivable (AR) analysis and collections - Claims follow-up (Workers Comp, Medicare, Medicaid, BCBS, Managed Care, Commercial Insurances) - Patient billing inquiries - Claims status verification (online, auto-response, and live calls) - Appeals for incorrectly processed claims - ICD-10, CPT, and HCPCS coding and review - Daily, monthly, and annual AR financial reporting - Custom report generation - Patient billing - Credentialing guidelines - Consulting/Training - Superbill review - Medical Coding Expertise - Accurate DX and CPT code assignment based on medical records - Correct DX pointer assignment - Modifier application for revenue maximization 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

Medical Billing Professional having 20 years of experience in Healthcare industry is seeking for employers, Medical Practices, Hospitals and Home Health Agency to work with on Medical Billing, Coding, Credentialing, Transcription and Virtual Assistant tasks. Having excellent written/oral communication skill which allows me to demonstrate my expertise with higher level of client's satisfaction. Detail oriented quality focused professional billing specialist. Successful track record of handling complicated assignments. Highly experienced In reconciling insurance and patient payments and resolving account disputes. Proficient in a variety of practice management software applications. Dedicated to maintaining strict patient confidentiality. Transcribe and edit recorded or written material, including operative reports, discharge summaries, patient history and examinations, physician letters and notes, and pharmacy, rehabilitation, autopsy, and x-ray reports. Collect statistical data to analyze departmental productivity. Oversee daily activities of department to optimize productivity and quality of work. Lead and guide employees performing related work; participate in hiring, interviewing, and training process of new transcriptions. Verify accuracy of patient information such as name and identification number; verify accuracy of transcription for correct punctuation, grammar, and spelling. Respond to inquiries for release of medical information, ensuring that legal requirements are followed and proper consent has been obtained. Maintain logs of medical procedures, incoming dictation, and transcription records. Follow established departmental policies, procedures, and objectives, continuous quality improvement objectives, and safety, environmental, and infection control standards. Distribute and collect dictation and transcribed reports; follow up on physician's missing and late dictation. Key Skills Medical Billing Insurance Credentialing Revenue Cycle Management AR Follow-Up Denial Management Medicare Medicaid Mental Health Billing Eligibility Verification Prior Authorization ICD-10,CPT-10, & Medical Terminology Medical Insurance Excellent Interpersonal Skills Excellent Phone Skills Various Practice Management Software Claim Entry & Payment Posting Records Organization & Management Insurance & Patient Aging HIPAA Compliance Online Claim Submission & ERA All EMR and EHR Systems I have extensive experience in the following Practice Management and EHR software. Kareo AdvancedMD AthenaCollector (by Athenahealth) NextGen Healthcare DrChrono eClinicalWorks Claim Scrubber PracticeSuite MediTouch (by HealthFusion) EZClaim MediFusion ChiroTouch CareCloud Central OpenPractice Solutions Office Ally Practice Mate MDConnection NueMD AllegianceMD CollaborateMD Medisoft TheraNest ChartLogic Cerner PowerWorks SimplePractice AccuMed Epic Systems Cerner Allscripts Meditech Aprima Amazing Charts

Valerie Donkoh – Your Reliable Medical Billing, RCM Specialist, and Credentialing EXPERT "Simplified Billing, Maximized Revenue – Let’s Optimize Your Revenue. Back Billing expertise, biller, collections, denial management, and credentialing. With 15+ years of experience in Medical Billing & Revenue Cycle Management (RCM), I help healthcare providers increase reimbursements, reduce denials, and improve cash flow. From accurate charge entry to efficient denial management, I ensure that your billing process runs smoothly and profitably, allowing you to focus on patient care. Why Choose Me? ✅ Comprehensive RCM Expertise I provide end-to-end revenue cycle management services, including charge entry, payment posting, AR follow-ups, denial resolution, insurance verification, and authorization requests. With expertise in 15+ medical billing software and insurance portals, I efficiently manage your billing from start to finish. ✅ Precision & Efficiency Accurate claim submission is my top priority. I ensure error-free billing, reducing claim denials and ensuring timely reimbursements for your practice. ✅ Denial Management Specialist I specialize in identifying and resolving claim denials efficiently. My proactive approach minimizes rejections and ensures faster claim processing, helping you recover revenue that might otherwise be lost. ✅ Expert in Insurance Verification & Authorizations I handle insurance eligibility verification and pre-authorizations accurately, preventing claim delays and ensuring that all services are reimbursed smoothly. ✅ HIPAA Compliance & Data Security I strictly adhere to HIPAA guidelines, ensuring patient data security and full compliance with industry regulations. 📌 My RCM Services Include: ✅ Medical Billing: Complete billing solutions for all insurance types, including Medicare & Medicaid. ✅ Denial Management: Efficient handling of denied claims with prompt resubmissions and appeals. ✅ Insurance Verification: Ensuring eligibility and benefits verification for smooth claims processing. ✅ Authorization Requests: Managing pre-authorizations to prevent payment denials. ✅ AR & Collections Management: Follow-ups on outstanding claims to reduce aging balances. 📌 Specialties I Have Worked With: ✅ Primary Care ✅ Internal Medicine ✅ OB/GYN ✅ Cardiology ✅ Neurology ✅ Oncology ✅ Pain Management ✅ Pediatrics ✅ Radiology ✅ Endocrinology ✅ Chiropractic Care ✅ Psychiatry & Behavioral Health ✅ Physical Therapy ✅ Sleep Medicine ✅ Urology ✅ Pulmonology ✅ Allergy & Immunology ✅ Gastroenterology ✅ Dermatology ✅ Orthopedics ✅ Rheumatology ✅ Home Healthcare & More 📌 Software & Portals Expertise: ✅ Billing Software: Kareo, eClinicalWorks (eCW), AthenaHealth, DrChrono, Practice Fusion, AdvancedMD, Allscripts, CureMD, Lytec, Medisoft, ChiroTouch, Cerner, NextGen, and more. ✅ Insurance Web Portals: Availity, Navinet, UHC, Cigna, Aetna, Humana, BCBS, Medicare (CGS, WPS, Palmetto GBA), Tricare, Medicaid, Molina Healthcare, HealthFirst, and others. Why Work With Me? ✅ Certified Medical Biller with deep knowledge of end-to-end RCM processes. ✅ Proven Track Record in Denial Management – reducing denials and increasing reimbursements. ✅ 100% Accuracy Guarantee – every claim is reviewed for compliance and correctness before submission. ✅ Free Performance Audits – offering insights into revenue opportunities and improvements. ✅ 24/7 Support Availability – responsive and reliable assistance whenever needed. ✅ Customized Billing Strategies – tailored solutions based on your practice’s specific needs. Let’s Optimize Your Billing & Boost Your Revenue! If you’re struggling with denials, delayed reimbursements, or inefficient billing processes, I’m here to help! Let’s work together to streamline your revenue cycle and maximize your earnings. Contact me today for a consultation, and let’s make your billing process seamless and profitable! Best Regards, Valerie Donkoh

HIPAA-certified Medical Billing Specialist with extensive experience managing leading Healthcare clients in the U.S.A. for years as a Revenue Cycle Management Specialist. I have In-depth knowledge of medical terminology and billing processes, especially in denial management. BILLING SOFTWARE EXPERTISE - AdvancedMD PM and EHR - eClinicalWorks (ECW) - Kareo (Tebra) - CollaborateMD - Carecloud - Medisoft - Athena - Dr Chrono - OFFICE ALLY - Practice Fusion - e-MED - CriterionsEHR - Practice EHR - All Scripts - Centricity - NextGen - RXNT - Simple Practice About Me: -Certified Medical Biller -RCM manager and Account Receivable Specialist -Credentialing and Enrollment -Medical Billing Auditor 𝐊𝐞𝐲 𝐒𝐤𝐢𝐥𝐥𝐬: -Medical Billing & Coding: Expertise in ICD-10, CPT, and HCPCS codes, ensuring accurate claim submissions. -Insurance Claims Processing: Proficient in managing claims with various insurance providers, including Medicare, Medicaid, and private insurers. -Revenue Cycle Management: Skilled in handling the entire revenue cycle, from patient registration and billing to payment posting and account reconciliation. -Denial Management: Proactively identify and resolve claim denials, reducing rework and improving reimbursement rates. -Compliance & Regulatory Knowledge: Thorough understanding of HIPAA, healthcare regulations, and payer policies to ensure compliant billing practices. If you are looking for the below service, please reach out: 1. Insurance Verification 2. Patient Demographics Entry 3. Eligibility Check 4. Claims Entry 5. Claims Submission 6. Claims scrubbing 7. Prior Authorizations 8. Correct Usage of ICD10, CPT and Modifiers 9. Payment Posting 10. Denials Management 11. AR Follow-ups 12. Provider Setups 13. Credentialing and Application follow-ups 14. Generate month-end reports using advanced Excel functions for management reporting. Expertise: Coding (ICD-10-CM, ICD-10-PCS, DRG, HCPCS Level II, CPT, modifier) Durable Medical Equipment (DME) Optometry and Ophthalmology PHYSICAL THERAPIST Acupuncture Home Health Anaesthesiology Cardiology Skilled Nursing Facility Dermatology Endocrinology Family Practice Gastroenterology General Surgery Internal Medicine Otolaryngology Pathology Pediatrics Physical Medicine and Rehabilitation Psychiatry Radiology Podiatry Radiotherapy Rheumatology Urology Behavioural and mental health Primary care Chiropractic Emergency Labs Orthopedics Radiology Telemedicine Telehealth Pain Management Anesthesia

I am a highly skilled and HIPAA Certified Medical Biller with over 7 years of extensive experience in the US healthcare industry. Specializing in medical billing and coding, insurance claim processing, and reimbursement procedures, I have developed a deep understanding of the intricacies involved in managing billing tasks for a diverse range of medical specialties. One of my key strengths lies in my proficiency with various billing software systems, including eCW (eClinicalworks), AdvancedMD, KAREO, Nextgen, CareCloud, Brightree, AdvancedMD, CureMD, Medisoft, Mod-Med, DrChrono, Niko Health and Athena. This expertise allows me to navigate these platforms seamlessly and efficiently. I have gained hands-on experience working with many medical specialties, such as Internal Medicine, Pathology, Orthopedic, Anesthesia, DME, Nephrology, Chiropractic, Allergy and Immunology, Dermatology, Diagnostic radiology, Emergency medicine, Family medicine, and Medical genetics. In my role, I excel in executing a wide range of billing tasks with utmost precision and accuracy. These include verifying eligibility through insurance portals for each patient, generating and submitting claims daily, whether electronically or on paper, for all payers, including government, commercial, workers' compensation, personal injury protection, out-of-network, and in-network providers. I ensure that all billing entries adhere to ICD-10 coding guidelines and state LCD regulations, allowing for swift and error-free billing procedures. My expertise extends to addressing unpaid claims and denials promptly, ensuring timely payment and a steady cash flow. I handle patient, insurance carrier, and employer queries with efficiency and professionalism. I possess the ability to apply payments and adjustments accurately, resolve immediate denials, work on denied/rejected claims based on EDI reports, and update patient and insurance demographics accordingly. Central to my approach is a strong commitment to maintaining compliance with HIPAA regulations and safeguarding the confidentiality and security of patient information. I possess exceptional communication skills, which enable me to foster effective collaboration with healthcare providers, insurance companies, and patients alike. If you are seeking a dependable and seasoned HIPAA Certified Medical Biller who can expertly manage all aspects of your medical billing process, I invite you to reach out to me. I would be delighted to discuss how I can contribute to streamlining your medical billing operations and optimizing your revenue cycle management.

With 15+ years of experience in U.S. medical billing and revenue cycle management, I help healthcare practices recover lost revenue, reduce claim denials, and improve cash flow within 30–60 days. *If you have an Aging AR (90+ 120+ 180+ 365+ days) *Frequent claim denials or underpayments *Delayed reimbursements from insurance *Billing errors slowing down cash flow I can help you fix it fast and compliantly. As I have helped 50+ practices collect millions of untapped dollars from their pending account receivables. -What I Focus On (Revenue-Driven Work Only) *Accounts Receivable (AR) Recovery – Aggressive follow-up on unpaid & aged claims *Denial Management – Root-cause analysis, appeals, and prevention *Clean Claim Submission – Reducing rejections before they happen *Payment Posting & Reconciliation – Accurate and timely processing *Insurance Follow-ups (Medicare, Medicaid, Commercial) Results You Can Expect *10-20% boost in Revenue *Faster claim turnaround * Collections from old accounts receivable. *Clean, organized billing workflow -Systems & Tools Care Cloud | Niko Health | Medisoft | Advanced MD | Athena | eClinicalWorks | Office Ally | Tebra | Simple Practice | Therapy Notes | NextGen and few others. Who I Work Best With Small to mid-sized practices (1–10 providers) Mental health, chiropractic, and private clinics DMEs and Laboratories Practices with AR backlog or denial issues Let’s Fix Your Revenue Cycle I am offering a Consultancy service to discuss tailored Revenue Cycle Management (RCM) solutions. I will be pleased to provide valuable insights on how to optimize your revenue stream. Send me a message, and I’ll be happy to help!

You will get complete Revenue Cycle Management (RCM), credentialing, and administrative support in one streamlined service. I provide end-to-end medical billing and coding solutions, helping healthcare providers maximize revenue, minimize denials, and stay compliant with industry standards. Medical Billing Services: Patient registration and demographics entry Insurance eligibility and benefits verification Pre-authorization request and follow-up Charge entry and superbill review ICD-10, CPT, HCPCS code validation and modifier usage Scrubbing and submission of electronic and paper claims Rejected claims correction and resubmission Clearinghouse reports review and reconciliation EOB and ERA research via insurance websites and batch systems Insurance and patient payment posting Denial management and AR follow-up (calls, portals, and appeals) Refunds, collections, and overpayment resolution Patient billing and follow-up communication Appointment scheduling and calendar updates Customized and standard financial reporting Accounts Receivable (AR) Follow-Up: • Prioritize and resolve unpaid claims based on aging and payer response • Contact insurance companies via calls and portals to determine claim status • Coordinate reprocessing and appeals for denied or underpaid claims • Evaluate patient insurance details and update records accordingly • Transfer balances when coverage is insufficient • Track and request missing Explanation of Benefits (EOBs) • Implement corrections based on feedback from insurance representatives Credentialing and Provider Enrollment: • Primary source verification • CAQH profile setup and maintenance • PECOS and NPPES enrollments and updates • Filing and submitting applications to Medicare, Medicaid, and commercial payers • Re-credentialing and revalidation for existing providers • License verification through state authority portals • Contract evaluations and payer negotiations • Payer grid maintenance and login management • Status follow-ups and credentialing record-keeping • Form submission and tracking for Aetna, Cigna, Humana, UHC, BCBS, Anthem, and others Medical Specialties Supported: • Internal Medicine • Family Practice • Pediatrics • Psychiatry & Mental Health • Chiropractic • Urology • Pain Management • Physical Therapy • DME • General Surgery • Behavioral Health • Gynecology & Obstetrics • Orthopedics • Radiology • Cardiology • Emergency Medicine • Telehealth and Virtual Care • Pathology • Endocrinology • Anesthesiology • Dermatology • Gastroenterology • Neurology • ENT • Ophthalmology • Rheumatology • And more EHR, PMS & Clearinghouse Experience: • Tebra (Kareo), AdvancedMD, AthenaHealth • ECW, CareCloud, SimplePractice • Practice Fusion, DrChrono, Office Ally • IntakeQ, MDVision • CollaborateMD, Medisoft, e-MED, RXNT • Allscripts, NextGen, Centricity, Synamed • Trizetto, ClaimMD, Waystar, Availity • Change Healthcare, GatewayEDI, Apex, Zirmed, Optum EDI I work with providers across multiple U.S. states and ensure that each project receives full dedication, accuracy, and timely delivery. My commitment is to offer reliable solutions that improve operational efficiency and increase your revenue. Best regards, Raamish