I have been working as a Medical Biller and Denials Specialist in US Medical Billing healthcare companies for the past 11 years in a US Healthcare Business. 

From a Medical billing specialist, Account Receivable, EDI Analyst to Management level had almost performed all the tasks related to medical billing. I was part of the company's top management so in that way mostly involved in making marketing strategies and guiding marketing executives in their projects. The financial analysis has also been done for different projects. I have also experience communicating with US doctors and other third-party healthcare staff i.e. insurances, doctors, clearinghouses, and other third-party payers.

Below is the details of my experiences for the past 11 years.

A. MEDICAL BILLING SERVICES

• Eligibility & Benefits verification.
• Appointments Scheduling
• Credentialing guidelines with payers
• Patient Demographics and Charge entry.
• Insurance claims submission via clearinghouse and Paper submission
• Accounts receivable and Denial management.
• Payment Posting.
• Patient billing for (Copay, Co-insurance & Deductible etc)
• Claims F/U on denials from insurances like Workers Comp, Medicare, Medicaid, BCBS, Managed care, and Commercial Insurances (Aetna, BCBS, Cigna, UHC, Oxford, etc...
• Claim status from insurance Portal and calls.
• Submitting appeals for denied claims
• ICD 10, CPT, and HCPCS Coding review.

B. SPECIALITIES 

• Durable Medical Equipment.
• Optometry and Ophthalmology
• Physical Therapy
• Chiropractic
• Acupuncture
• Behavioral Health
• Ambulatory Surgery
• Home Health
• Anesthesiology
• Cardiology
• Skilled Nursing Facility
• Dermatology
• Emergency Medicine
• Family Practice
• Gastroenterology
• General Surgery
• Internal Medicine
• Orthopedic
• Pediatrics
• Physical Medicine and Rehabilitation
• Psychiatry
• Radiology
• Podiatry
• Urology

C. PMS SOFTWARE WORKED ON: 

• Simple Practice
• AdvancedMD
• Carecloud
• Practice HER
• Kareo HER
• Office Ally
• Docutap
• Therabill
• ECW
• Medisoft
• Criterions
• Dr. Chrono
• Athenanet
• Medisoft ETC

D. CLEARING HOUSE WORKED ON: 

• Trizetto
• Optum EDI
• Availity
• Apex
• Zirmed
• Emdeon
• Change Healthcare

It is my believe that unless you work with honesty and hardworking, you cannot achieve 100%. Making strong and professional relationship with my clients is my top priority. Thank you for viewing my profile. I am looking forward to hearing from you.