• Processed and submitted medical claims for reimbursement, ensuring accuracy and compliance with insurance policies and coding regulations.
• Worked extensively with top HMOs in Missouri, including UnitedHealthcare, Anthem, Blue Cross Blue Shield, Aetna, etc. to manage claims, denials, and appeals.
• Utilized billing software including DrChrono, Simple Practice, and Tebra, as well as payer portals (Availity, Navinet, Novitasphere, UHC) for eligibility verification, claim tracking, and payment posting.
• Reviewed and corrected coding errors, ensuring proper CPT, ICD-10, and HCPCS code usage to maximize reimbursements.
• Coordinated with healthcare providers and insurance companies to resolve claim issues, negotiate payments, and appeal denied claims.
• Verified patient insurance coverage, obtained prior authorizations, and handled patient billing inquiries professionally.
• Maintained accurate records of billing transactions and prepared detailed reports for financial analysis and compliance audits.
• Ensured adherence to HIPAA regulations and best practices in medical billing and patient data confidentiality.
