Work for Professional In Network Providers for multiple states such as New york, New Jersey, and PennsylvaniaAR Follow up, Daniels handling, Provide the solutions and educating other teams about new policies and guideline of Medicare and Medicaid and other commercial insurances.Working on assigned Correspondence, Assigned Task, Emails of Clients, Special projects, Making protocols and policies. Trained new Resources. Etc.Obtaining referrals and pre-authorizations as required for procedures.Checking eligibility and benefits verification for treatments, and procedures.Reviewing patients bills for accuracy and completeness, and obtaining any missing information.Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.Following up on unpaid claims within standard billing cycle timeframe.Calling insurance companies regarding any discrepancy in payments if necessary. Patient's inbound calls, dispute , queries and issues etc.Identifying and billing secondary or tertiary insurances.Reviewing accounts for insurance of patient follow-up.Researching and appealing denied claims.Answering all insurance telephone inquiries pertaining to assigned accounts.Setting up patient payment plans and work collection accounts.Updating billing software with rate changes.Updating reports.Evaulation of every team member and do trainings where required.

Work for Out of Network Providers for Emergency Rooms billing. (TEXAS STATE)

Work on Rejections, Denials, and AR follow up.
Work on PS (patients service) queries which includes Patients calls etc.
Work on Covid claims.
Work in client emails, EOBs denials.
Posting payments.
Payment boosting, through Appeals, Negotiations from third parties such as DataIsight, Zelis, Multiplan, Viant & GCS etc.
Payment boosting through TDI(Texas Department of Insurances.
Payment hunting.
Making multiple reports such as AR Claim Aging, Appeal Aging, Submission MTD, Workplan, Activity, Services analysis and any specific requirement.
Education to other teams such as Denial Management, Patient Statements, Payment Posting & Coding team.
Work on DM queries.
Training to the new members.
Providing the guidelines and fee schedules.
Provide resolutions to fix the problems permanently as well as to reduce down the human efforts.
Provide the platforn to communicate with other teams.
Preparations of meeting agendas.
Provide the analysis.
Activity verifications of team.
Provide the education materials.
Give Word and excel training to other members to enhance their skill which increase their efficiency of work.

Work for Professional In & Out Network Providers for multiple states such as Texas, New york, Kentucky, New Jersey, Arizona. AR Department, Daniels handling, Provide the solutions and updating and educating to other teams about new policies and guideline of Medicare and Medicaid and other commercial insurances.
Working on assigned EOBs ,ERAs, Assigned Task, Emails of Clients, Control plan aging, Making rule of SCRUBBER, BRE, ERE, VBA etc. Trained new Resources. Etc. Obtaining referrals and pre-authorizations as required for procedures.
Checking eligibility and benefits verification for treatments, and procedures. Reviewing patient bills for accuracy and completeness, and obtaining any missing information.
Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
Following up on unpaid claims within standard billing cycle timeframe.
Checking each insurance payment for accuracy and compliance with contract discount. Calling insurance companies regarding any discrepancy in payments if necessary, Identifying and billing secondary or tertiary insurances.
Reviewing accounts for insurance of patient follow-up. Researching and appealing denied claims. Answering all insurance telephone inquiries pertaining to assigned accounts. Setting up patient payment plans and work collection accounts. Updating billing software with rate changes. Updating reports. Evaulation of every team member and do trainings where required.