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概要
Detail-oriented Medical Billing Specialist with 3 years of experience managing complete Medical billing Revenue Cycle Management. Investigates and resolves insurance claims, Aging Report, Recovery from denied claims, and disputes and communicates with patients and insurances/third parties regarding claims balances resulting major increase in Provider Monthly reimbursement.
Brief intro of me-
I did master in Computer Sciences
My Medical Billing RCM experience includes:
1- Eligibility Benefits
2- Referral Authorization
3- Charge Entry or Billing
4- Rejection Handling at clearing house and Payer level
5- Denial Management/Aging Reports/Charge Reports/Payment Reports
6- Payment Posting
7- Payers and Patients AR collections services.
8- Reporting and analysis
I started my carrier as Medical Biller, AR follow up (Claim Inquiry Specialist). HIPAA privacy rules & compliance awareness. From a Medical billing specialist, AR, EDI Analyst to Management level had almost performed all the tasks related to Medical billing. I am a quick learner, ability to follow instructions and multitask to meet deadlines.
Moreover, I have worked with Different clients and helped Medical billing Companies as Medical biller, AR specialist. 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.
Medical Billing Services includes the following: -
- To check Eligibility and verification of patient’s health benefits from insurance carrier’s website and through Phone.
- 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 Plans and Commercial Insurances (Aetna, BCBS, Cigna, UHC, Molina and many more...
- 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
- Daily, Monthly and annual AR Financial reports preparation
- Custom reports where required
- Patient billing as per instructions
- To research the right DX and CPT code according to medical records
- Provide right DX pointers for the first time to avoid payment delays or to avoid from NCD/LCD denials
Billing types I have worked on: - (Professional Billing)
I have complete knowledge of CMS-1500 form that is use for Professional Billing.
- Diagnostic, Pathology, Toxicology Labs.
- Multi-specialist Doctors
Softwares I have worked on: -
- Eclinicalworks (ECW)
- Care Cloud
- Practice mate (Office Ally)
项目
工作经历
Medical Biller & A/R Representative (Claims Inquiry Specialist)
• I am a Medical Biller
Medical billing is the process of submitting and following up on claims to insurance companies in order to receive payment.
Medical billing translates a health care service into a billing claim.
The responsibility of the Medical Biller in a health care facility is to follow that claim to ensure the practice receives reimbursement for the services that providers perform.
Although a medical biller’s duties vary with the size of the work facility, the biller typically assembles all data concerning the bill. This can include charge entry, claims transmission and etc.
• I am Accounts Receivable (A/R) Representative (Claims Inquiry Specialist)
The responsibilities of A/R Rep follow up on pending claims, insurance follow-up and patient follow-up, posting payments. A/R Rep regularly communicates with physicians and other health care professionals to clarify diagnoses or to obtain additional information.
I have excellent skills to run any type of Medical Billing Software i.e.
• Care Cloud
• E Clinical Works (ECW)
• Office Ally
Moreover any type of billing software can be run after taking simple quick overview of required one.
HR Officer
SS Fabrics (Pvt) Limited
HR Officer
Job Responsibilities
1-
Job responsibilities in HRM System(
Assist in implementation of controls in order to ensure system reliability.
Made effective suggestions to improve internal controls which were implemented and duly
appreciated.
Assisted management in understanding various risks and implemented in the Payroll that helped to
increase work efficiency.
Participated in special investigations and reviews employee misconduct.
Responsible to check all the implementation according to company policies and procedures.
Preparation of salaries, wages, overtime and personnel records of permanent, daily wages, and piece
rated employees of all departments.)
2-
I am also being working on Inventory management system, Gate management system(
Maintain all types of arrival and out going, ensuring demands against purchased products, feeding
demands, GRN against purchased products, issuance of purchased products, calculating monthly
consumption on behalf of this issuance.)
3-
I am also being working on Spinning management system(
Ensuring arrival of raw materials (Misc Cotton usually).
keep maintain stock of raw materials.
Daily issuance from this stock.
keep maintain Finished products (Usually Yarn) stock.
Ensuring all type of dispatches from this finished goods.
Then finally calculating profit and loss at every month end.
4-
Keep maintain of Sale Tex record.
Collecting Sale , Purchase and Export invoices and maintain complete hard and soft documents
record for annual Sale Tex audit.
Data Entry Operator
Worked in Knitting IT.
