In my role as a Medical Biller/Accounts Receivable specialist, I have developed a comprehensive skill set to efficiently manage the revenue cycle process. I excel in conducting meticulous charge entries for all claims intended for submission to payers, ensuring adherence to Point of Service (POS) requirements and coherence between diagnosis and procedure codes. With a keen eye for accuracy, I verify payor IDs and addresses, review and approve claims prior to submission, and confirm the precision of provider pay-to addresses.
My expertise extends to performing patient payment postings, generating detailed monthly aging reports, and closely monitoring all claims for follow-up. I possess a proactive approach, evidenced by my thorough review of previous notes and Explanation of Benefits (EOB) before contacting insurers and adept retrieval of EOBs from payor portals. Moreover, I am skilled in validating system ledgers, crafting compelling letters of appeal for aged claims, and implementing necessary modifications to diagnosis and CPT codes to address denials effectively. I am proficient in navigating secondary insurance coverage complexities, accurately handling balance billing or patient invoicing when secondary coverage is unavailable.
Additionally, I possess strong administrative skills, including the submission of claims and essential documents to secondary insurances via fax or electronic platforms, as well as managing W9 form submissions for facility address changes. My skill set is further complemented by my ability to submit medical records through payer portals to address denial reasons, analyze EOBs to determine claim status, and transmit referrals as needed. Furthermore, I prioritize patient satisfaction by promptly addressing inquiries regarding their balances through phone calls.
Skills/ Area of Expertise:- HIPAA trained- Google Workspace proficiency- Strong organization and strategic planning abilities- Effective time-management skills- Proficient in online research- Expertise in various Medical Billing Software including TEBRA/KAREO,E CLINICAL WORKS (ECW), ATHENA HEALTH, and MOD MED- In-depth insurance knowledge- Excellent verbal and written communication skills- Critical thinking and problem-solving abilities- Strong coordination and interpersonal skills- Adaptability and teamwork capabilities- Exceptional attention to detail
Tools:- TEBRA/KAREO- ATHENA ONE- MOD MED- Availity- United Healthcare- G Suite- Canva- Microsoft Office Suite- Microsoft Teams- Skype- Dropbox With my comprehensive skill set and proficiency in various tools and software, I am well-equipped to contribute effectively to any medical billing team.
