Hello, I look forward to working 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 for 6 years in a US-based -----------om a Medical billing specialist, Claim Specialist, Pre-Authorization Specialist to Management level. I had almost performed all the tasks related to Medical billing. As Operations Manager, I lead the group of 8 employees and look after all of their administrative and operational tasks.
As a medical billing specialist and Operations Managers I have worked on Company top priority projects. I have worked on the highest priority projects and acquisitions assigned by the company CEO and GM. I have also experience communicating with US doctors and other third party healthcare staff i.e. insurances, doctors, nurses and other third-party payers.
A) Medical Billing Services includes the following:-- Checking Eligibility and verification of patient’s health benefits from an insurance carrier’s website and through Phone and Portal.- 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- ICD10, CPT and HCPCS Coding and/or review, Encoder pro Expert licensed version guided for correct coding- Appeals
(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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