SteadyMedical

HIPAA Certified Medical Billing Specialists/Credentialing Specialist | Upwork/Fiverr /LinkedIn

Fiverr • Freelance

Nov 2013 - Present • 12 yrs 9 mos

I am a skilled **Medical Billing & Coding Specialist** and **Revenue Cycle Management (RCM) Expert** with over **13 years of experience** in medical billing, coding, credentialing, and healthcare administration. I have extensive experience managing the complete medical billing cycle, including **insurance verification, charge entry, claims submission, payment posting (ERA/EOB), denial management, appeals, accounts receivable (AR) follow-up, and provider credentialing**, while ensuring compliance with payer guidelines and HIPAA regulations in high-volume healthcare environments. I am proficient in **ICD-10, CPT, and HCPCS coding**, insurance verification, prior authorization, referrals, claims processing, and medical data entry using leading medical billing software and EHR/EMR systems. I provide customized **medical billing and RCM solutions** that help healthcare providers increase revenue, reduce claim denials, and improve cash flow. I have successfully completed multiple projects on **Fiverr** and **Upwork**, working with a wide range of healthcare providers and medical practices. My experience includes **Urgent Care, Primary Care, Internal Medicine, Mental Health, ABA Therapy, Physical Therapy, Occupational Therapy, Speech Therapy, Diagnostic Laboratories, Family Medicine, Chiropractic, Home Health, and multi-specialty medical practices.** I have successfully worked in roles such as **Medical Billing Specialist, Medical Coding Specialist, Revenue Cycle Management (RCM) Specialist, Prior Authorization Specialist, Insurance Verification Specialist, Referral Coordinator, Credentialing & Enrollment Specialist, Accounts Receivable (AR) Specialist, Payment Posting Specialist, Claims Submission Specialist, Medical Data Entry Specialist, and Healthcare Virtual Assistant.

Account Manager/Medical Billing Specialist | Care Cloud

CareCloud • Freelance

Sep 2014 - Sep 2018 • 4 yrs

► Review patient accounts and medical claims to ensure accuracy, completeness, and compliance while resolving any missing or incorrect information. ► Perform **Insurance Eligibility & Benefits Verification (VOB)** to confirm active coverage, copays, deductibles, coinsurance, and authorization requirements. ► Manage both **in-network and out-of-network provider participation**, including payer enrollment and participation status. ► Prepare and deliver **daily, weekly, and monthly billing, collections, AR, and revenue cycle reports** for clients. ► Handle the complete **provider credentialing and enrollment process**, including CAQH, Medicare, Medicaid, and commercial insurance applications. ► Investigate, appeal, and follow up on **denied, rejected, and unpaid insurance claims** to maximize reimbursements. ► Independently manage the entire **Revenue Cycle Management (RCM)** process from patient registration through final payment collection. ► Perform accurate and timely **charge entry, claim submission, and payment posting** while maintaining a high level of billing accuracy. ► Monitor and manage **Accounts Receivable (AR)** by conducting consistent follow-up with insurance companies to reduce outstanding balances and improve collections. ► Analyze denial trends and implement effective **denial management and appeals** to minimize future claim rejections. ► Communicate proactively with insurance carriers to resolve claim issues and maintain a consistent cash flow for healthcare providers. ► Maintain professional and timely communication with healthcare providers, practice managers, and office staff regarding billing updates and account status. ► Track and monitor **Key Performance Indicators (KPIs)**, including clean claim rate, denial rate, AR aging, reimbursement turnaround time, and collection performance. ► Post payments accurately from **ERA, EOB, EFT, and patient payments**, ensuring proper reconciliation and account balancing.