For the past two years, I have worked in the healthcare industry, with a strong focus on both pharmacy and medical billing claims. This dual experience has given me a comprehensive understanding of the healthcare revenue cycle from multiple
----------- my medical billing experience, I have successfully managed the full claim lifecycle, from initial submission to final payment. This includes:Claim Processing and Submission: I am proficient in submitting claims to various payers, including Medicare, Medicaid, and commercial insurance companies. I have a solid understanding of the procedures for electronic and paper claim submission and consistently ensure accuracy to minimize errors.ICD-10 and CPT Coding: I have practical experience applying ICD-10 and CPT codes to ensure claims are accurate and compliant with industry regulations. I am skilled at reviewing patient charts and documentation to assign the correct codes, which is crucial for preventing
-----------nial Management and Appeals: A key part of my role has been identifying and resolving denied claims. I am adept at analyzing Explanation of Benefits (EOB) forms, determining the reason for denial, and taking the necessary steps to appeal the decision. My persistence has been instrumental in recovering revenue for the organization.Software Proficiency: I am experienced with cisco, allworx, precis and am a quick learner when it comes to new systems. I am comfortable navigating billing software to manage patient accounts, track claims, and generate
reports.My background in pharmacy claims further enhances my abilities. It has given me a deeper insight into the front-end patient process, including insurance verification and copay collection, which helps me identify and troubleshoot issues before they become billing problems.
