Medical Billing Specialist

Review and accurately enter patients data in the EMR/ EHR Systems such as Office Ally, Tebra, Prompt and Athena.

I have a client whose claims are frequently denied. To identify the issue, I thoroughly reviewed the submissions and consistently contacted the insurance company for clarification and understand the issues. After following their instructions, the payment has now been successfully processed.

I have encountered numerous denials, primarily due to missing medical necessity documentation, incorrect input , or documents being submitted without proper labeling. To minimize future denials, I will consistently use a checklist to review everything before claim submission.

Responsible for the process of billing and payment of patient accounts, ensuring accurate, timely reimbursement, and correct claims generation that should be filed with the insurance providers, with a follow up on the outstanding claims. In case of billing queries, work with patients to pay through setting up a payment plan if necessary and settlement of outstanding balances. With monitoring of the account trends and looking out for denied or delayed claims, I can help identify these issues so that overall accounts receivable aging and cash flow from the practice could be brought down.

In customer service, you get annoyed frequently. Sometimes, you have to deal with some clients or patients who are always in a hurry. You never fight with them. That is why you listen to their plea and solve it in such a way that you are done with the problem as soon as possible.

Payment Posting I just use tools such as Availity,Navinet, Novitasphere, and UHC. Usually Im just always follow-up on unpaid claims in a timely manner to reduce AR.

EHR'S have greatly improved efficiency and patient care, despite some challenges with technical issues and data entry. The benefits, including enhanced coordination and compliance, make the transition worthwhile.

In my experience with medical billing, attention to details has been critical in ensuring accuracy and minimizing errors. By thoroughly reviewing patients information, coding, and documentation, I've been able to reduce claim denials and ensure that claims are submitted correctly the first time. I consistently double-check for accuracy in patients demographics, insurance details, and procedure codes, which helps prevent costly mistakes or delays in payment. While this level of detail can be time-consuming, it ultimately results to smoother claim processing and better compliance with insurance requirements. This careful approach has significantly improved the efficiency of billing operations and contributed to maintaining a healthy revenue cycle.

When it comes to claim processing, it enhances revenue cycle management. However, handling denials and follow-ups can be very challenging and time-consuming, often taking 30 to 45 minutes to answer my call or it takes hours response to my calls or emails.

In my experience I can do follow-up on outstanding claims while updating patient records in the system. Respond to all calls from patients inquiries regarding their bills and insurance coverage. Review and submit claims for various patients to several insurance companies.