STOP LOSING HOURS TO INSURANCE HOLD MUSIC AND CLAIM RE-SUBMISSIONS.
As a Medical Biller focused on Revenue Cycle Management (RCM), I take the weight of claims processing off your shoulders by ensuring every patient demographic is verified and every CMS-1500 is tracked to completion. I don’t just submit claims—I manage the process so you can reclaim your time for patient care.
HOW I PROTECT YOUR CASH FLOW:
- Front-End Accuracy: Precise patient intake and insurance eligibility/benefits verification.
- Clean Claims: Meticulous claim creation, submission, and proactive tracking.
- Revenue Recovery: Diligent AR follow-up and accurate ERA/EOB payment posting.
- Software Ready: Proficient in Office Ally, Availity, and PTEverywhere (EHR/EMR).
I am a HIPAA-compliant medical biller focused on minimizing avoidable denials through meticulous follow-through and ICD-10/CPT accuracy. I am highly organized, detail-oriented, and looking for a long-term role where I can grow with your practice.
Ready to stop chasing payments? Send me a message today and let’s get your billing back on track!
Comprehensive Medical Billing Technical Index
I. Core Revenue Cycle Management (RCM) & Claims Processing:
Full Cycle Medical Billing | Front-End Billing Operations | Back-End Revenue Recovery | Claim Cycle Management | Clean Claim Rate (CCR) Optimization | CMS-1500 Claim Form Preparation | UB-04 Institutional Billing | HIPAA 5010 Transaction Standards | Electronic Data Interchange (EDI) | Clearinghouse Gateway Management | Claim Scrubbing | Manual Claim Entry | Batch Submission | Real-Time Claim Tracking | Secondary & Tertiary Claim Filing | Coordination of Benefits (COB) | Crossover Claims | Corrected Claims (Frequency Code 7) | Voided Claims (Frequency Code 8) | Timely Filing Monitoring.
II. Coding, Documentation & Medical Necessity:
ICD-10-CM (International Classification of Diseases, 10th Revision) | CPT (Current Procedural Terminology) | HCPCS Level II (Healthcare Common Procedure Coding System) | Medical Coding Compliance | Category II & III Codes | CPT Modifiers (25, 59, 95, GP, GO, GN, XP, XS, XE, XU) | Evaluation and Management (E&M) Leveling | Superbill Analysis | Encounter Form Auditing | NPI (National Provider Identifier) Type 1 & Type 2 | Taxonomy Code Verification | Place of Service (POS) Codes | Procedure-to-Diagnosis Mapping | Medical Necessity Verification | Local Coverage Determinations (LCD) | National Coverage Determinations (NCD).
III. Insurance Eligibility & Verification (Front-End):
Insurance Benefits Verification | Eligibility Checking | Primary, Secondary, and Tertiary Coverage | HMO, PPO, EPO, and POS Plan Logic | Medicare Part B | Medicaid Managed Care | Blue Cross Blue Shield (BCBS) FEP & Commercial | UnitedHealthcare (UHC) | Aetna | Cigna | Humana | Tricare | Workers' Compensation | Personal Injury Protection (PIP) | Letter of Protection (LOP) | Prior Authorization (PA) | Pre-Certification | Referral Tracking | Patient Financial Responsibility | Deductible Tracking | Co-insurance Calculation | Copay Reconciliation.
IV. Accounts Receivable (AR) & Denial Management:
AR Aging Report Management (0-30, 31-60, 61-90, 91-120+ Days) | Denial Root Cause Analysis | Rejection Resolution | Denial Management Software | Insurance Appeals (Level 1, 2, and 3) | Redetermination Requests | Reconsiderations | Fair Hearing Support | Insurance Takebacks & Offsets | Credit Balance Resolution | Unapplied Credits | Overpayment Recovery | Recoupment Management | Payer Correspondence | Insurance Representative Communication | Claims Follow-Up | Out-of-Network (OON) Negotiations.
V. Payment Posting & Financial Reconciliation:
EOB (Explanation of Benefits) Analysis | ERA (Electronic Remittance Advice) Processing | 835 Transaction Set | Electronic Payment Posting | Manual Payment Posting | Patient Statement Generation | Patient Ledger Reconciliation | Daily Deposit Balancing | Batch Reconciliation | Financial Reporting | Revenue Integrity | Write-offs & Adjustments | Contractual Allowances | Patient Collections Support | Merchant Account Integration.
VI. Software, Compliance & Systems:
Office Ally Service Center | Availity Essentials Portal | PTEverywhere Practice Management | EHR (Electronic Health Records) | EMR (Electronic Medical Records) | Patient Portals | HIPAA Privacy & Security Rules | PHI (Protected Health Information) Security | HITECH Act Compliance | Data Entry Integrity | Microsoft Excel (Formulas, VLOOKUP, Pivot Tables) | Google Workspace | Cloud-Based Billing Systems | Remote Billing Operations | Virtual Private Network (VPN) Security | Encrypted Communication.
VII. Specialized Billing Contexts:
Physical Therapy (PT) Billing | Occupational Therapy (OT) Billing | Speech-Language Pathology (SLP) Billing | Mental Health Billing | Behavioral Health (LCSW, LMFT, LPC) | ABA (Applied Behavior Analysis) | Chiropractic Billing | Solo Provider Support | Multi-Specialty Group Billing | Outpatient Rehabilitation |