MBA, Professional Medical Biller/RCM with Customer/Data-Entry Services
Very Dedicated, Attentive, Quality-focused, Result-Oriented Upwork Professional, provides best-in-class, end-to-end Medical Billing/AR/Denials/Rejections/Coding services, as a US Healthcare/RCM Domain Expert, MBA with 14+ years of experience in Medical Billing (Revenue Cycle Management) Domain and handled lot of different specialty practices, and worked on number of Practice Management Softwares, and also worked on Medical Coding of ICD-9 CM, CPT-4, HCPCS, and Modifiers. Also using all the tools like AMA's ICD-10 Coding Book, AMA's CPT-4 Coding Book (Adobe Digital Edition), ICD-10 Coding Smartphone Mobile Application, Optum Encoder Pro Medical Coding Software to work on ICD-10 CM codes.
Expert in Data-Entry services, .pdf conversion, Office Management, Database management.
Extremely productive and effective in a high volume, high stress, environment.
Provides excellent customer service in a TAT (Turn-Around Time), meeting all SLAs (Service-Level Agreements), and positively contribute to give the out-of-the-box solutions as a Healthcare Consultant to clients/customers in their business growth.
Ability to quickly learn, adapt, accurate and efficient in the work, as always focus on quality of services. and provides unique business ideas, where we have always the scope of improvement.
a) Medical Billing Services includes the following:-
- To check Eligibility and verification of patient¿s health benefits from insurance carrier¿s website and Via 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 and decision making for Collections
- Strong claims follow up on denials from insurances like Workers Comp, Government payers, Managed care and Commercial Insurances (Aetna, BCBS, Cigna etc.)
- Patient billing inquiries as per received information from your office
- To check claim status from insurance auto response unit and via live calls.
- To make on call appeals for reprocessing of incorrectly processed claims based on billing knowledge
- ICD-9 CM, ICD-10 CM, CPT-4 and HCPCS Coding and/or review
- Monthly and annual reports preparation
- Custom reports where required
- Patient billing as per instructions
- Credentialing guidelines
- EDI/ERA/EFT setup
- Super bill review
(b). Medical Coding
- To research the correct 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
- Family Practice
- Infectious Disease
- Orthopedic Surgery
- Internal Medicine
- Sports Medicine
- Pain Management
- Chiropractic Services
- Therapy (Physical, Occupational, Speech)
- DME (Durable Medical Equipment)
Would be my extreme pleasure to provide you my services.