Imaa

Medical Billing Team Lead

Medical Expert Solutions • Temps plein

Jan 2022 - Present • 4 yrs 4 mos

* Manage the full revenue cycle for healthcare providers across multiple states, including Texas, Michigan, Florida, and Delaware, from patient registration to final reporting and reconciliation. * Perform insurance eligibility verification, benefits confirmation, and prior authorizations to minimize claim denials and delays. * Review provider documentation and ensure accurate CPT, ICD-10, and HCPCS coding for all services. * Prepare and submit electronic claims via clearinghouses, monitor acknowledgments, and resolve rejections to maintain high clean-claim rates. * Handle accounts receivable (AR) follow-up, track unpaid or underpaid claims, communicate with commercial payers, Medicare, and Medicaid, and manage appeals or corrected submissions. * Post payments accurately, including Electronic Remittance Advice (ERA) and manual posting; reconcile adjustments, write-offs, and patient balances. * Generate patient statements and respond to patient and provider billing inquiries via phone and email to maintain transparency and positive relationships. * Manage email communications related to billing operations and lead client meetings to review revenue cycle performance, resolve issues, and implement process improvements. * Prepare detailed reports and analyze revenue trends, denial patterns, and key performance indicators (KPIs) to identify opportunities for operational and financial improvements. * Utilize multiple medical billing platforms, including eClinicalWorks (eCW), AdvancedMD, CareCloud, Tebra (Kareo), and TheraNest by Ensora, adapting quickly to new systems and workflows. * Ensure full compliance with HIPAA and payer regulations while maintaining accuracy, efficiency, and confidentiality in all billing processes. **Key Achievements:** * Successfully managed the complete revenue cycle for multiple providers across different states, reducing denials and improving clean-claim rates. * Streamlined communication with patients, providers, and clients