I have performed all feasible action to boost up and recover maximum reimbursement for multi-specialty professional claims as senior account receivable executive for a year. After successful professional grow I was chosen for coding lesson and promoted to ambulatory surgical centers. Currently I am dealing with CMS-1500 and UB-04 processional and institutional claims as in network and out of network facility. I have strong understating to negotiate OON claims, filing low payment appeals and prepare arbitration packets for underpaid NF and WC claims to initiate for arbitration process.

I have started working as accounts receivable specialist on professional provider (Pulmonary Specialist) hospital claims while making monthly follow-ups EDI Rejections, handling denials and written appeals on denied claim. And after that I was transferred to Infections diseases specialist doctor’s office infusion and home infusion with the basic responsibilities of
ï‚· Follow-ups on new claims
ï‚· EDI Clearing house rejections
ï‚· Objections/denials handling on claims
ï‚· Perform targeted collection steps on past due claims
ï‚· Filling appeals on denied claims to health insurances
ï‚· Filling appeals to department of insurances
ï‚· Re-verifying patient benefits
ï‚· Solving coordination of benefits issues
ï‚· Authorization filing (New and Retro)
ï‚· Referrals requesting (New and Retro)

ï‚· Perform initial client assessment and analysis to begin credentialing process.
ï‚· Filling new National Provider Identifiers
ï‚· Set-up and update CAQH portals
ï‚· Preparing W-9 forms
ï‚· Sending letters of intent to insurance to get new contracts
ï‚· CLIA waiver applications for Medical providers
ï‚· Contract filing, making follow-up and troubleshooting the credentialing process
ï‚· Software implementations