Medical Billing Specialist
(American Medical billing office (Storm Cairo
Total years of experience :18 years, 3 Months
Medical Billing Specialist Jan 2008 to present
Storm Cairo Billing office
Storm Technologies Ltd. "the main company" is based in Houston- TX- USA while the Egyptian branch is an offshore account where all of technical work is done.
Professional Skills:
• Patient Data Coding
• Claim Entry and Payment Posting
• Records Accuracy
• Insurance Liaison
• Claims Denial Follow-up
• Insurance and Patient Aging
• Bad Debt Reporting
• Patient Statements Review
Technological Skills:
• ICD-9, ICD-10, CPT
• Electronic Remittance Advice (ERA's)
• EDI Insight, Navicure, Gateway EDI
• Electronic Medical Billing
• HCFA 1500 forms
Key Achievements:
• Improved revenue for most recent provider over 25% with same patient load
• Successfully obtained payments from many delinquent accounts by constantly following up on them
• Increased instances of insurance claims payment by effectively creating EFT depositing accounts for providers
• Ensure claims are entered and submitted with 24 hours of receipt
Professional experience:
• Set up new patient accounts.
• Insure accuracy of insurance claims by verifying correct ICD-10 and CPT codes.
• Enter and submit claims electronically to insurance.
• Verify patient eligibility and deductible status before sending claims to insurance.
• Follow up on rejected claim in clearing house.
• Retrieve Electronic Remittance Advice (ERA's).
• Accurately apply payments to patient accounts
• Send secondary claims upon processing of primary insurance.
• Send Patient statements, answer and resolve patient billing inquires
• Follow up on Insurance Denials by contacting insurance to get the exact reason for denial to correct
• Re-submit corrected claims to insurance as necessary bearing in mind the timely filing restrictions
• Follow up on Insurance and patient aging
• Contact insurance companies to update the provider's information and enroll providers with the insurance companies also to inquire on provider credentialing status.
• Create system reports to provide the management with information on billing procedures and outcomes
• Identify and resolve patients’ billing problems and discrepancies
o Sending and receiving faxes and E-mails and answering the incoming calls besides being responsible for the Applicant's database.
o Entering and revising the applicants' information in excel spreadsheets and keep it in a certain order to facilitate the searching process.
o Contacting job applicants providing them with the recently available vacancies in gulf area.
o Handling the Business correspondence tasks with our customers offering them new services or responding to their offers.
o Selecting the suitable candidates for each vacancy according to the required qualifications and coordinate between both candidates and employers.
o Interviewing the new applicants for internal positions and evaluating them according to their language skills (Language interviewer).