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Click here or scroll down to respond to this candidateCandidate's Name
Email: EMAIL AVAILABLELINKEDIN LINK AVAILABLEPhone: PHONE NUMBER AVAILABLEProfessional SummaryDetail-oriented and quality-focused Medical Billing Specialist with extensive experience in handling complex billing processes, reconciling insurance and patient payments, and resolving account disputes. Proven track record in enhancing revenue streams and ensuring compliance with coding standards. Proficient in multiple practice management software applications and committed to maintaining strict patient confidentiality. Professional ExperienceRichmond Interventional Pain Management, Staten Island, NY Billing Specialist/SupervisorAugust 2020 Present Responsible for all aspects of medical billing, including claims submission, scrubbing, correction of denied/rejected claims, and payer follow-ups. Appealed denied claims after investigating and analyzing the reasons for denial. Improved revenue consistency for providers by optimizing billing processes for approximately 300 patients weekly. Conducted thorough research on CPT and ICD-10 coding discrepancies to ensure compliance and accurate reimbursement. Streamlined patient eligibility verification and claims status checks using online payer portals and direct insurance agency contacts. Developed monthly cash flow reports and implemented new workflow efficiencies, enhancing overall billing operations. Enhanced patient communication, explaining billing details such as copayments, coinsurance, deductibles, and coverage issues, thereby improving patient understanding and satisfaction. Actively communicated with insurance companies to resolve disputes, secure timely payments, and clarify claim details, ensuring swift resolution of billing issues and maintaining robust revenue streams. Managed and processed workers compensation and no-fault claims, working closely with respective attorneys to ensure accurate documentation and expedite claim resolution. Responsible for claim posting and the processing of payments, ensuring all financial transactions are accurate and up to date. Out of Network Experience: Proven track record of handling Out of Network billing processes effectively. Patient and Payer Refunds: Managed patient and payer refunds for overpaid claims or payments made in error, ensuring timely and accurate processing of all refunds.A&U Medical Billing, Edison, NJInternshipJanuary 2020 July 2020 Prepared and submitted clean claims to various insurance companies electronically and on paper. Monitored patient accounts for non-payments, delayed payments, and other irregularities, ensuring swift resolutions. Engaged in daily communications with insurers like Medicare and Blue Cross to address claim resolutions and rejections.PNIT INC, Edison, NJAnalystNovember 2017 December 2019 Utilized Excel extensively to validate and analyze data, implementing macros to streamline processes. Managed extensive data queries using MS-SQL Server, generating reports on a daily, weekly, monthly, and quarterly basis.Education Medical Billing and Coding, AIMS Education, Piscataway, NJ Bachelor of Engineering, VTU, Karnataka, IndiaCertifications Certified Billing and Coding Specialist (CBCS) Certified Microsoft Office Specialist: Word, Excel, Outlook, PowerPoint HIPAA Certified Biologix SolutionsSkills Medical Billing & Coding: Expertise in managing medical bills, using CPT code modifiers, and understanding ICD-10 and CPT terminology. Proficient in medical billing and coding software. Insurance Knowledge: Strong grasp of insurance terminology and processes, including HIPAA regulations, Medicare, Medicaid, Workers Comp/NF, and private insurance. Skilled in explanation of benefits (EOB). Financial Skills: Experienced in claim posting, insurance verification, payment processing, financial reporting, and process improvement. Software Proficiency: Proficient in Microsoft Office (Word, Excel, PowerPoint, Outlook), EMR/EHR systems, and various billing and invoicing software. Communication & Interpersonal Skills: Excellent data entry skills, effective communicator, strong interpersonal skills, and ability to function well as a team member. Multitasking & Organizational Abilities: Demonstrated multitasking abilities, adept at maintaining accuracy and efficiency in high-pressure environments. |
