Sajad Ali

US medical billing, mental health and physical therapy RCM, credentialing and denial management

Fiverr • Freelance

Feb 2024 - Present • 2 yrs 3 mos

Medical Billing & Revenue Cycle Management (RCM) Specialist with over 6 years of experience supporting US-based healthcare providers, clinics, and group practices. I specialize in optimizing billing workflows, reducing claim denials, and improving reimbursement timelines through accurate and compliant processes. My expertise covers the full revenue cycle, including medical billing and coding (ICD-10, CPT, HCPCS), insurance verification (eligibility and benefits), clean claim submission, denial management with root cause analysis, accounts receivable follow-up (30/60/90+ days), and payment posting with reconciliation. I also provide patient billing support to ensure smooth financial communication. In addition to billing, I have strong experience in credentialing and provider enrollment, including Medicare, Medicaid, and commercial payers. I handle CAQH profile management, NPI (NPPES) setup, and ERA/EDI/EFT enrollments while ensuring compliance with payer requirements. I have worked extensively with leading EHR and billing systems such as Athenahealth, Kareo/Tebra, AdvancedMD, SimplePractice, TherapyNotes, eClinicalWorks, NextGen, Office Ally, and WebPT, along with clearinghouses like Availity, Waystar, and Change Healthcare. My niche focus includes mental and behavioral health billing, as well as physical, occupational, and speech therapy. I also have experience with chiropractic, DME, NEMT, and home health services. I am committed to accuracy, compliance, and consistent follow-up, helping providers achieve higher clean claim rates, reduced denials, and improved cash flow.

Medical Billing & Credentialing Specialist | AR, Denials, RCM | HIPAA

Upwork • Freelance

Jan 2024 - Present • 2 yrs 4 mos

I am a professional Medical Billing and Credentialing Specialist with hands-on experience in full-cycle Revenue Cycle Management (RCM) for healthcare providers, private practices, clinics, and billing companies across the United States. My expertise covers end-to-end billing processes including patient demographics verification, insurance eligibility and benefits verification, charge entry, CPT ICD-10 HCPCS coding, claim submission, and payment posting with accurate ERA and EOB reconciliation. I specialize in denial management, appeals, and accounts receivable (A/R) recovery, ensuring that denied or underpaid claims are properly analyzed, corrected, and followed up to maximize reimbursements. I have extensive experience working with Medicare, Medicaid, Tricare, VA, and major commercial payers such as BCBS, UHC, Aetna, Cigna, and Humana. My approach focuses on submitting clean claims, reducing rejection rates, improving collection ratios, and maintaining compliance with HIPAA regulations. In addition to billing, I provide complete provider credentialing and enrollment services including CAQH profile setup and maintenance, PECOS enrollment, NPPES NPI registration, and payer enrollment for both government and commercial insurance networks. I ensure accurate documentation, timely submissions, and continuous follow-up to avoid delays and accelerate approvals. I am proficient in industry-leading billing software such as Kareo Tebra, Athenahealth, AdvancedMD, eClinicalWorks, NextGen, DrChrono, Practice Fusion, TherapyNotes, SimplePractice, Office Ally, and clearinghouses like Availity, Waystar, and Trizetto. My goal is to help healthcare providers streamline billing operations, reduce administrative burden, recover lost revenue, and improve overall financial performance through efficient, accurate, and compliant RCM processes.