You will get credentialing & payer enrollment to secure in-network patients
Project details
You will receive a comprehensive and professional credentialing and enrollment service that ensures your provider applications are completed accurately and submitted on time. With extensive experience in healthcare administration and payer processes, I understand the complexities of credentialing and will handle every step—from document collection to follow-up—with precision and care. My goal is to streamline the process, reduce delays, and secure your provider’s enrollment efficiently, so you can focus on patient care. I am committed to clear communication, confidentiality, and delivering high-quality results that meet payer requirements and industry standards.
Project Type
OtherWhat's included
| Service Tiers |
Starter
$70
|
Standard
$100
|
Advanced
$150
|
|---|---|---|---|
| Delivery Time | 30 days | 30 days | 45 days |
Number of Revisions | 1 | 1 | 1 |
About Arshad
Medical Billing | RCM Consultant | IDR/NSA Consultant
Pakistan, Pakistan - 7:50 am local time
With 8+ years of proven success in U.S. healthcare Revenue Cycle Management, I help practices maximize collections, reduce denials, and ensure compliance. I’ve directly increased revenue by up to 50% for some clients, managed 50+ provider accounts, and led operations across 25+ states, supporting teams of 400+ staff and $30M+ monthly collections.
Expertise Across the Entire RCM Cycle:
• Front-End: Eligibility verification, prior authorizations, demographics & insurance capture, referral management.
• Coding & Charge Capture: CPT/ICD-10/HCPCS alignment, documentation review, clean-claim readiness.
• Billing & Submissions: CMS-1500/UB-04, ANSI 837P/I, clearinghouse management, payer portals.
• Payment Posting & Reconciliation: ERA/EOB posting, 835 reconciliation, EFT/ERA enrollment.
• AR & Denials: AR work queues, root-cause denial analysis, timely appeals, underpayment audits, backlog recovery.
• Out-of-Network, IDR & TDI: Skilled in Independent Dispute Resolution (IDR) and TDI processes, securing fair reimbursements for OON claims.
• Credentialing & Onboarding: CAQH/NPPES/PECOS setup, payer enrollment, revalidations, EDI/ERA/EFT onboarding for new providers and clinics.
• Audits, Compliance & KPIs: HIPAA adherence, internal audits, gap analysis, dashboards for clean-claim rates, first-pass yield, denial %, and days in AR.
• Process Improvement: Lean/Six Sigma methods to reduce waste, standardize workflows, and implement automation.
Key Achievements:
• Boosted collections by up to 50% through denial reduction, process optimization, and staff training.
• Successfully handled 50+ client accounts, ensuring consistent performance, compliance, and cash flow.
• Designed scalable onboarding workflows enabling rapid expansion for multi-location practices.
• Led high-volume AR cleanups, recovering significant aged receivables in record time.
Specialties:
Denial Management & Appeals
AR Recovery & Backlog Projects
Provider Credentialing & Rapid Onboarding
Out-of-Network & IDR/TDI Dispute Management
Personal Injury (LOP) Coordination with Law Firms
Compliance & Audit Readiness
Approach:
Assess current workflows, KPIs, and payer mix.
Deliver actionable solutions for quick wins and sustainable improvements.
Implement clear SOPs, train staff, and provide transparent reporting.
If you need a hands-on RCM partner who delivers measurable results, cleaner claims, fewer denials, faster reimbursements, and revenue growth, let’s connect. I’m flexible with U.S. time zones and committed to driving tangible financial improvements for your practice.
Steps for completing your project
After purchasing the project, send requirements so Arshad can start the project.
Delivery time starts when Arshad receives requirements from you.
Arshad works on your project following the steps below.
Revisions may occur after the delivery date.
Gather Provider Documents
Request and review the provider’s completed application, licenses, certifications, NPI, malpractice insurance, W-9, and any other required documents to ensure completeness before submission.
Submit Applications to Payers
Ensure all documents are accurately completed and attached. Submit applications through payer portals or via mail/fax as required. Track submission confirmations and follow up as needed.