Este perfil está escrito en inglés
Demonstrated experience with Athena.
Demonstrated experience with AthenaOne.
Demonstrated experience with Epic.
Demonstrated experience with eClinicalWorks.
Demonstrated experience with Kareo.
Professional profile
Performed comprehensive revenue integrity audits to identify coding inaccuracies, denial trends, revenue leakage, and reimbursement opportunities.. Reviewed provider documentation, coding practices, and claim submissions to ensure compliance and optimize reimbursement.. Analyzed revenue cycle performance data to identify recurring issues impacting collections and payment turnaround times.. Collaborated with billing, coding, and provider teams to implement corrective actions and improve claim quality.. Educated providers and coding staff on documentation best practices, coding accuracy, and regulatory compliance.
Performed inpatient and outpatient coding reviews utilizing ICD-10-CM, CPT, and HCPCS guidelines.. Reviewed clinical documentation for completeness, specificity, and coding accuracy.. Conducted quality assurance audits and compliance reviews to maintain coding standards.. Supported onboarding initiatives and coding education efforts.. Performed pediatric coding reviews, ensuring accurate ICD-10-CM, CPT, and HCPCS code assignment, documentation compliance, and adherence to payer-specific guidelines.. Utilized AthenaOne and related healthcare systems to support efficient remote coding workflows.
Managed full-cycle medical billing operations including claim submission, payment posting, account reconciliation, and insurance follow-up.. Investigated, appealed, and resolved denied, underpaid, and unpaid claims.. Verified insurance eligibility, benefits, and coverage requirements.. Communicated with insurance carriers, providers, attorneys, and patients to resolve billing issues.. Payment posting from both insurance carriers manually, electronically & from No fault/workers compensation carriers along with patient payments.. Processed high-volume claims across neurology, podiatry, primary care, and additional specialties.. Communicated with patients regarding their balance, understanding HIPAA guidelines & patient confidentiality.. Communication with office front desk, providers & medical assistants.
Scheduled diagnostic imaging appointments and verified insurance coverage and patient eligibility.. Assisted with Workers' Compensation and No-Fault case administration.
Supported billing operations through payment posting, eligibility verification, and claims follow-up.. Obtained prior authorizations for imaging & prescriptions, processed referrals, and assisted with denial resolution.