An ambitious and experienced young professional who strive to be result oriented. I have 8 years experience in medical billing, medical claims processing, follow up and management of medical billing process in all aspect (data entry, payment posting, denial resolution, patient and provider support). During my job in a US based medical billing company I had worked in almost all fields of medical billing (starting from data entry as billing executive to management of medical billing process as manager operations, manager special projects,...
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(a). Medical Billing Services includes the following:-
To check Eligibility and verification of patientís health benefits from insurance carrierís 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
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
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MTBC - Healthcare IT Company. (US Based)
Manager Operations and Billing Team Leand
2005 - 2011
Ensuring profitability of Operations and supervising all aspects of Medical Billing management including claim charges, claim submission, payment posting, follow up and/or...