Highly skilled and HIPAA-certified Medical Billing Specialist / RCM Specialist / AR Specialist with over 5 years of experience in revenue cycle management and claims
processing. Expertise in insurance verification, denial resolution, and optimizing reimbursement processes. Adept at collaborating with healthcare providers, patients, and insurance companies to ensure accurate and timely payments. Proficient in multiple billing software programs, ensuring compliance with industry regulations.
>Perform charge entry, ensuring accuracy and completeness in claim details.
>Manage claims submission, processing electronic and paper claims for Medicare, Medicaid, and private insurance carriers.
>Conduct Accounts Receivable (A/R) follow-up, investigating unpaid claims and resolving outstanding balances.
>Handle denial management, identifying reasons for denials and submitting timely appeals to maximize reimbursement.
>Oversee payment posting, ensuring accurate reconciliation of patient accounts and payer remits.
>Prepare and process appeals, providing necessary documentation and follow-up to overturn claim denials.
>Do outbound calls to different insurance companies to verify patient coverage, check claim statuses, and resolve payment discrepancies.
>Verify patient insurance coverage, ensuring eligibility and benefits are correctly recorded.
>Maintain compliance with HIPAA, state, and federal billing regulations
