Senthil Kumar Ganesan
Expert Medical Biller/CPC Certified Coder
I am working in US Healthcare for last 9 years and having very good working experience in end to end process in medical billing. From Insurance caller, Medical billing specialist, AR, EDI Analyst to team handling level had almost performed all the tasks related to Medical billing. I have also experience to communicate with US third party healthcare staff i.e. insurances, doctors, clearing houses and other third party payers.
My entire working experience let me to know about their end to end process. 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 and their HMO’s, 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 - 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 in Anesthesiology, Chiropractic, Physical Therapy, General Medicine, Family Practice, Dentrix, Gastroenterology, Bariatric surgery and FQHC services. Knowledge to utilize web support for all process like checking eligibility, claim status, claim entry through online (DDE), Insurance’s current updating, etc.,
Further my wife (Mageswari) working as a Medical coder for last two years and she is a CPC certified holder and she giving a very good support related to coding issues.
Good working knowledge in most billing software like Vericle, Medisoft, Fox Meadow, Centricity, Office Manager (Dentrix), Nextgen, etc