Medical billing specialist/Patient Services(Call center)/RCM Billing
Value I can add to your project and how can I be the best candidate for your project?
Well I love what I do; I'm serious about being a long-term success. My ultimate goal is to provide error free work and focus on continues improvement by applying Six Sigma Methodology in service delivery for my clients.
What do I provide to my client?
1-Provide Reliable & Cost Effective Solutions
2-Provide First Time Resolution (FTR)
3-Service Delivery within Turn Around Time (TAT)
4-Innovative & Continuous Improvement in service.
5-Provide Quality work & unlimited Customer Support.
1-Provide Reliable & Cost Effective Solutions 2-Provide First Time Resolution (FTR) 3-Service Delivery within Turn Around Time (TAT) 4-Innovative & Continuous Improvement in service. 5-Provide Quality work & unlimited Customer Support.
I began my career as an AR executive with a NASDAQ listed company where I performed various activities. I have worked as Project Manager and Quality Controller with some of the top most USA healthcare outsourcing company. I am Six Sigma Green Belt certified and have completed lean, asset and Quality certificate courses. I have received several awards and certificates for my work like Best QCA of the year 2012,2013, one Gold and Silver star for best performance, Star performer of all quarter.
My expertise is in several areas of Medical billing and Transcription. I have worked on all function of medical billing (Patient registration, Transcription, Insurance Verification, charge entry, coding, Payment posting, AR follow up, Collection and Refund) and also did quality check for same. I have also prepared training manual for AR and payment posting. I always try to identify opportunity to improve billing cycle and focus on continuous improvement in process by applying six sigma methodologies. I have worked for below mentioned specialties of provider’s claim.
6. Family Practice
8. General surgery
9. Gynecology and obstetrics
10. Internal Medicine
13. Physical Medicine and Rehabilitation
14. Physical Therapy
18. Skill Nursing Facility
I have exposure of working on below mentioned functions of Medical billing and also did quality check for same.
1. Patient Registration
2. Insurance Verification
3. Pre Authorization Request and verification
4. Charge Posting / Super bill review
5. Evaluation of valid HCPCS codes, ICD 9-10 and Modifier
6. Work on Edits of rejected electronic claims
7. Checking clearing house reports (Emedeon, Availity,Web md)
8. Provider PIN calling ( for verifying provider TAX id, NPI and billing address)
9. EOB and check search via websites and batches
10. Payment Posting
11. AR Follow up on denied claims via call or websites
12. Appeal project
13. Collection / Refund
Current Job Responsibility
1. Daily audit of sample size.
2. Publishing weekly /monthly dashboard, production and accuracy report to client.
3. Working on new projects to improve process accuracy and productivity.
4. Doing calibration with QCA, Team leader and SME to reduce process variances.
5. Tracking or identifying root causes and process variances.
6. Conducting PKT (Process knowledge test) to bridge the knowledge gap.
7. Suggesting corrective actions, implementing solutions and reviewing implementation
8. Providing feedback and refresher training to individual and team.
9. Doing remotely and side by side audit of associates
10. Analyzing trends in quality check data and finding variations and their root causes.
Work Experience of Software
I have work experience of below mentioned software in medical billing. I have very good
grasping power so it will not take much time to navigate new software.
1. Medical Manger ( MM 9 and 10 version)
4. Prognosis Pro
5. Practice Fusion
6. Athena EMR
9. E-Clinical Works