Customer Service Associate

Overview

Looking for full-time work (8 hours/day)

at $6.00/hour ($1,056.00/month)

Bachelors degree

Last Active

February 26th, 2025 (5 days ago)

Member Since

December 14th, 2022

Profile Description

Hello! I'm Upgrade to see actual info, a dedicated Accounts Receivable professional with extensive expertise in Revenue Cycle Management (RCM). With a keen focus on optimizing financial processes, I specialize in ensuring timely payments, denial management, medical billing and enhancing profitability for healthcare organizations.

What I Bring to the Table:

Industry Expertise: In-depth knowledge of RCM practices, including billing, collections, denial management, and insurance eligibility.

Payer Eligibility Expertise: I bring extensive experience and a deep understanding of insurance eligibility processes in both medical and dental office settings. I am adept at identifying Coordination of Benefits (COB) and navigating various insurance plans. Furthermore, I have a strong familiarity with payer eligibility tools, including Availity, OneSource, and Front Runner.

Denial Management Expertise: I am highly proficient in managing and fighting denials with payers, leveraging my extensive knowledge of appeal writing and denial resolution strategies. My in-depth research skills, grounded in CMS guidelines and NCCI edits, empower me to effectively challenge denials. I consistently go the extra mile to explore alternative solutions and options to overturn denials, ensuring that claims are resolved in favor of our practice.

Account Receivable Follow UP and Payment Posting Expertise: I possess a robust knowledge of insurance follow-up strategies to effectively reduce aging accounts in accounts receivable. My proactive approach includes calling payers to obtain updates on submitted claims and engaging with patients regarding their medical bills to ensure clarity and prompt resolution. Additionally, I have strong technical skills in insurance and patient payment posting, including tracking invoices, identifying missing payments, and preparing comprehensive payment reports. My commitment to accuracy and timely communication helps optimize revenue cycle processes and enhance overall financial performance.

Medical Billing: I possess in-depth knowledge of medical billing for various laboratory tests, including PCR Testing, drug testing, and chemistry testing. My expertise extends to accurate CPT/HCPCS coding, with a strong understanding of modifier applications to avoid bundling denials and ensure compliant claims submission. I am well-versed in the critical role of DX codes in supporting relevant CPT/HCPCS codes, which enables me to optimize claims for payment and minimize denial errors. With robust research skills, I effectively utilize online resources to verify coverage of specific DX codes under LCD CMS guidelines, ensuring that claims are accurately coded and reimbursable. My expertise in navigating complex billing and coding regulations, combined with my analytical skills, enables me to identify and resolve coding discrepancies, resulting in improved revenue cycle efficiency and reduced denial rates.

Technical Expertise:
NextGen CRM Proficiency: Skilled at leveraging NextGen CRM to streamline operations, manage patient interactions, and enhance billing efficiency.

Carestak CRM Expertise: Experienced in utilizing Carestak CRM for effective patient communication and financial management, building treatment plans, and driving improved patient outcomes and collections.

Advanced MD Expertise: Proficient in creating macros, collections menu, action codes, and more, with exceptional knowledge of the end-to-end process of AdvancedMD.

Analytical Mindset: Strong ability to analyze financial data, detect discrepancies, and implement corrective measures to enhance the overall RCM process.

Detail-Oriented: Meticulous attention to detail ensures accuracy in invoicing and collections, effectively reducing days in accounts receivable.

My Approach:
I prioritize building transparent relationships with clients, fostering open and informative communication. My goal is to exceed expectations through the implementation of best practices and innovative solutions that enhance financial performance.

Services Offered:
- Accounts Receivable Management
- Revenue Cycle Analysis
- Billing and Collections
- Denial Resolution
- Financial Reporting and Insights
- Insurance Eligibility for Medical and Dental

Let’s work together to optimize your accounts receivable processes and boost your financial health! I am excited to collaborate and contribute to your success in the healthcare sector. Feel free to reach out to discuss your needs and how I can assist you.