Customer Service Representative

Overview

Looking for full-time work (9 hours/day)

at $16.00/hour ($3,168.00/month)

Bachelors degree

Last Active

January 31st, 2025 (today)

Member Since

June 2nd, 2020

Profile Description

Hello! My name is Upgrade to see actual info, a dedicated all around virtual assistant who can help you take care of your business to the next level. I have worked as a Medical Biller and Claims Specialist in US healthcare companies.
I have worked 10+ years in a US Healthcare Business. From a Customer Service Representative, Technical Support Representative, Medical Billing Specialist, Account Receivable. I've almost performed all the tasks related to Medical billing. I have also experience to communicate with US doctors and other third- party healthcare staff i.e insurances, doctors, clearing houses and other third party payers.
A. MEDICAL BILLING SERVICES
- Eligibility & Benefits verification.
- Appointments Scheduling.
- Credentialing guidelines with payers.
- Patient Demographics and Charge entry.
- Insurance claims submission via clearing house and Paper submission.
- Accounts receivable and Denial management.
- Payment Posting. 
 - 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 THERAPIST, Chiropractic, Accupuncture, Behavioral Health, Ambulatory Surgery, Home Health, Anaesthesiology, Cardiology, Skilled Nursing Facility, Dermatology, Emergency Medicine, Endocrinology, Family Practice, Gastroenterology, General surgery, Internal Medicine, Orthopedic, Otolaryngology, Pathology, Pediatrics, Physical Medicine and Rehabilitation, Psychiatry, Radiology, Radiotherapy, Rheumatology, Urology
C. PMS SOFTWARES WORKED ON:
Freshdesk, Brightree, NextGen, Xifin, Flims, AdvancedMD, Zendesk, Availity and One Healthcare/ Linx.
I have great experience of working on below mentioned functions of Medical billing.
1. Patient Registration
2. Insurance Verification
3. Pre Authorization Request and verification
4. Charge Posting / Super bill review
5. Evaluation of valid HCPCS codes, ICD 9-10 and Modifier
6. Fixing Rejected Electronic claims
7. Checking clearing house reports
8. Provider PIN calling ( for verifying provider TAX id, NPI and billing address)
9. EOB and check search via websites and batches
10. Payment Posting of Insurance and Patient
11. AR Follow up on denied claims via call or websites
12. Appeal project
13. Collection / Refund / Over-Payment
14. Scheduling new patients
I am confident that I can help you with the following tasks:
• Benefits and eligibility verification
• Pre Authorization Request and verification
• Medical Billing
• Account Receivable Representative 
 • Administrative Task
Major follow up Insurance
1. Medicare
2. Medicaid
3. BCBS
4. Aetna
5. UHC
6. Cigna
7. Molina
8. Tricare
9. MVA
10. Humana
11. Self pay
I believe in hard work and honesty. I am always interested in making long-term professional relationships with my clients and will never complete the project until the client is 100% satisfied.
Thank you for viewing my profile.