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Familiar with ICD-10 coding, CPT codes, modifiers, Medical Terminologies, Insurance Billing processes and guidelines, clearinghouse rejections, credentialing, prior authorization, insurance verification, etc.

I am a research analyst

✅Medical Billing and Coding

I have worked on all functions of medical billing and also did quality checks for the same. I have also prepared a training manual for AR and payment posting. I have great experience working on the below-mentioned functions of Medical billing.

✅Patient Registration
✅Insurance Verification
✅Pre Authorization Request and verification
✅Charge Posting / Superbill review
✅Evaluation of valid HCPCS codes, ICD 9-10 and Modifier
✅Fixing Rejected Electronic claims
✅Checking clearinghouse reports (Phicure, Trizetto, availity and Navinet)
✅Provider PIN calling (for verifying provider TAX id, NPI, and billing address)
✅EOB and check search via websites and batches
✅Payment Posting of Insurance and Patient
✅AR Follow up on denied claims via call or websites
✅Appeal project
✅Collection / Refund / Over-Payment
✅Scheduling new patients Project Specialization

✅Credentialing & Enrollment Experience

Practice and provider credentialing, re-credentialing with all US government, commercial, managed-care payers/insurances of any provider or practice specialty.

✅Medicare, Medicaid, Medicare & Medicaid plans and commercial insurance and plans enrollment
✅Follow up on submissions of all enrollment every week
✅Getting Type 1 and Type 2 NPI through NPPES registry
✅ERA and EFT enrollments
✅Contract negotiations and fee schedule settlements
✅CAQH up to date, NPPES up to date and weekly track the issues and communicate with front office and providers.
✅Provider Directory maintenance
✅Maintain spreadsheet with following dates tasks regarding progress enrollment follow-up.
✅Daily & Weekly basis provider communication regarding enrollment concerns, missing information, and latest updates on enrollments.
✅Providers and NP’s/PA’s Hospital affiliation paper work and approval with any of desired hospital

✅Software Experience (PM and EMR)

Work Experience of Software I have work experience with the below software mentioned in medical billing. I have excellent grasping power, so it does not take much time to navigate new software. I am comfortable and adaptive with using many different types of medical billing software.

1. eClinicalWorks
2. AdvancedMD
3. eMedical Practice
4. All Scripts
5. Athena IDX
6. Trizetto
7. EZ Claim
8. Office Ally
9. Kareo
10. Simplifier
11. NexGen
12. Icanotes
13. Meditech
14. Ipatient Care
15. Prognosis
16. Dr. Chrono

✅Major follow up Insurance

1. Medicare
2. Medicaid
3. BCBS
4. Aetna
5. UHC
6. Cigna
7. Molina (Medicare, Medicaid and marketplace plans)
8. Tricare
9. ChampVA
10. Humana
11. Guardian
12. Oxford
13. Workers Compensation

Ability to control multiple assignments and tasks by identifying their level of importance • I have the ability to listen, writing and speaking effectively. • I have excellent interpersonal abilities that help me maintain a good relationship between my employer and colleagues. I am willing to be trained and open to learning new things. I am a fast learner and self-motivated. Looking forward to working with you","rawText":"I am a HIPAA certified Medical Biller, Coder, credentialing specialist and EDI analyst and have 8+ years of experience and counting. Familiar with ICD-10 coding, CPT codes, modifiers, Medical Terminologies, Insurance Billing processes and guidelines, clearinghouse rejections, credentialing, prior authorization, insurance verification, etc. I am a research analyst ✅Medical Billing and Coding I have worked on all functions of medical billing and also did quality checks for the same. I have also prepared a training manual for AR and payment posting. I have great experience working on the below-mentioned functions of Medical billing. ✅Patient Registration ✅Insurance Verification ✅Pre Authorization Request and verification ✅Charge Posting / Superbill review ✅Evaluation of valid HCPCS codes, ICD 9-10 and Modifier ✅Fixing Rejected Electronic claims ✅Checking clearinghouse reports (Phicure, Trizetto, availity and Navinet) ✅Provider PIN calling (for verifying provider TAX id, NPI, and billing address) ✅EOB and check search via websites and batches ✅Payment Posting of Insurance and Patient ✅AR Follow up on denied claims via call or websites ✅Appeal project ✅Collection / Refund / Over-Payment ✅Scheduling new patients Project Specialization ✅Credentialing & Enrollment Experience Practice and provider credentialing, re-credentialing with all US government, commercial, managed-care payers/insurances of any provider or practice specialty. ✅Medicare, Medicaid, Medicare & Medicaid plans and commercial insurance and plans enrollment ✅Follow up on submissions of all enrollment every week ✅Getting Type 1 and Type 2 NPI through NPPES registry ✅ERA and EFT enrollments ✅Contract negotiations and fee schedule settlements ✅CAQH up to date, NPPES up to date and weekly track the issues and communicate with front office and providers. ✅Provider Directory maintenance ✅Maintain spreadsheet with following dates tasks regarding progress enrollment follow-up. ✅Daily & Weekly basis provider communication regarding enrollment concerns, missing information, and latest updates on enrollments. ✅Providers and NP’s/PA’s Hospital affiliation paper work and approval with any of desired hospital ✅Software Experience (PM and EMR) Work Experience of Software I have work experience with the below software mentioned in medical billing. I have excellent grasping power, so it does not take much time to navigate new software. I am comfortable and adaptive with using many different types of medical billing software. 1. eClinicalWorks 2. AdvancedMD 3. eMedical Practice 4. All Scripts 5. Athena IDX 6. Trizetto 7. EZ Claim 8. Office Ally 9. Kareo 10. Simplifier 11. NexGen 12. Icanotes 13. Meditech 14. Ipatient Care 15. Prognosis 16. Dr. Chrono ✅Major follow up Insurance 1. Medicare 2. Medicaid 3. BCBS 4. Aetna 5. UHC 6. Cigna 7. Molina (Medicare, Medicaid and marketplace plans) 8. Tricare 9. ChampVA 10. Humana 11. Guardian 12. Oxford 13. Workers Compensation Ability to control multiple assignments and tasks by identifying their level of importance • I have the ability to listen, writing and speaking effectively. • I have excellent interpersonal abilities that help me maintain a good relationship between my employer and colleagues. I am willing to be trained and open to learning new things. I am a fast learner and self-motivated. Looking forward to working with you","canEdit":false,"editUrl":"https://www.workana.com/freelancer/1c2b2012b6189046ed96875379360e7c/profile/description","g11n":{"edit":"Editar","save":"Guardar","cancel":"Cancelar","warning":"Cuidado: No compartas datos de contacto o podrás ser bloqueado.","expandText":"Ver más detalles","collapseText":"retraer","placeholder":"Sintentiza en pocas palabras aquello que mejor te define como profesional. Muestra al mundo lo que puedes brindar para darle dirección a tu carrera freelance. 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