Assistant Manager : Medical Billing Department
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 years in a US-based company. From a Medical billing specialist, AR, EDI Analyst to Management level had almost performed all the tasks related to Medical billing. As Assistant Manager I lead the group of 200 employees and look after all of their administrative and operational tasks.
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.
• Hiring, training and coaching of staff.
• Training the fresh candidates for new hiring including (Pre & Post hiring)
• Accomplishes billing human resource objectives by assisting in selection of, orienting, training, assigning, scheduling, coaching and disciplining billing department employees
• Communicating job expectations
• Supervising the staff
• Planning, monitoring, appraising job contributions
• Implementation of strategies to improve, productivity, quality, and customer-service standard.
• Maintaining customer relations and resolves problems
• Identifying billing system improvements
• work closely with support staff, developers, and other departments to assure a high level of billing quality is provided
• Evaluating and improving methods by making required changes
• Creating and monitoring all billing procedures for the office
• Ensure claims are being submit in standard cycle.
• Set-up practice management software for submission of electronic claims to clearinghouse. Work with
clearinghouse to resolve file compatibility issues
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
- Super bill review
(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
• ICD &CPT
• 835 & 837
• Provider credentialing
• All kind of enrollments (EDI, ERA, EFT)
• Insurance web portal Sign Up & management
• Insurance& Patient Aging
• Financial & aging reports
• Appeal Filling & Denial Management
• Effective written and verbal communication and presentation skills
• Maintain Records ofOrganization&Management
• Excellent interpersonal skills and able to work with a variety of personality types
• Strong analytical skills; Ability to conduct research, creatively solve problems, and deal with ambiguity
• HIPAA Compliance