zain ali

Medical Biller Team Lead

CareCloud • Temps plein

May 2024 - Jul 2026 • 2 yrs 2 mos

Medical Billing Specialist CareCloud (MTBC) 2024 – 2026 • Led daily medical billing and Revenue Cycle Management (RCM) operations for US healthcare accounts. • Managed end-to-end billing processes, including claim creation, submission, claim status follow-up, corrected claims, and payer communication. • Reviewed CPT, ICD-10, and HCPCS coding information to support accurate claim submission and reduce billing errors. • Managed Accounts Receivable (AR) by monitoring outstanding claims, conducting timely follow-ups, and resolving payer-related issues. • Handled denial management by identifying denial reasons, taking corrective actions, and submitting corrected or resubmitted claims. • Performed insurance eligibility and benefits verification and ensured patient and insurance information was accurate before billing. • Reviewed EOBs and ERAs, supported payment posting, and reconciled account balances. • Communicated with insurance payers regarding claim status, denials, eligibility, payment issues, and billing discrepancies. • Maintained accurate billing documentation, account notes, claim records, and follow-up activities. • Coordinated billing tasks and supported team members with claim processing, AR follow-up, denial resolution, and payer-related issues. • Monitored pending accounts and prioritized follow-ups to support timely reimbursement and reduce outstanding AR. • Assisted in improving billing workflows, maintaining clean claims, and ensuring accurate and timely RCM processes. • Handled confidential healthcare information professionally while following appropriate privacy and compliance procedures.

Medical Biller

PMTAC Private Limited • Temps plein

Dec 2021 - Mar 2024 • 2 yrs 3 mos

• Managed end-to-end medical billing and Revenue Cycle Management (RCM) activities, ensuring accurate and timely claim submission, payment posting, and account follow-up. • Prepared and submitted clean claims to insurance payers while reviewing patient demographics, insurance eligibility, authorizations, CPT/HCPCS codes, ICD-10 codes, modifiers, and other billing information to minimize claim errors and rejections. • Followed up on unpaid, denied, rejected, and underpaid claims by reviewing payer responses, identifying root causes, correcting billing issues, and resubmitting claims when appropriate. • Performed insurance verification and eligibility checks to confirm active coverage, benefits, patient responsibility, and payer requirements before billing. • Worked on accounts receivable (AR) management, monitored outstanding balances, prioritized aging accounts, and performed consistent payer follow-up to improve collections and reduce AR days. • Posted insurance and patient payments accurately, reconciled payment information with EOBs/ERAs, and identified discrepancies, contractual adjustments, and outstanding balances. • Investigated claim denials related to eligibility, authorization, coding, missing information, timely filing, duplicate claims, and payer-specific requirements, taking corrective action to prevent recurring issues. • Maintained accurate patient and billing records while following HIPAA and healthcare data privacy requirements. • Communicated professionally with insurance companies and internal teams regarding claim status, payment discrepancies, denials, and outstanding balances. • Reviewed billing workflows and accounts for accuracy, helping maintain clean claims, improve reimbursement, and support an efficient revenue cycle. • Utilized medical billing systems and payer portals to research claim status, submit documentation, track follow-ups, and maintain detailed billing notes. • Demonstrated strong attention to detail, problem-solvin