Medical Billing Manager
Resume:
Koparkhairane, Vashi,
Navi Mumbai – 400 709
Sambhaji H. Mohite.
OBJECTIVE :
To achieve a position in a reputed Organization that will provide me an opportunity to make a strong
contribution to organizational goals through continued development of professional & personal skills.
WORK EXPERIENCE :
Present Employment : INVENTURUS KNOWLEDGE SOLUTION Pvt Ltd
Designation : Sr. Associate
Duration : Since April’12 to Till
Job Responsibilities: Billing Dept.
• Working in Medical Billing Process (SNR & BK2BL Dept.)
• Working on Next Gen, Document Manager & Quic Software
• Checking the rejection on gateway & identify the type of rejection (gateway rejection or payer rejection)
• Checking the pt’s details (Name, DOB, Insurance, Subscriber) with the help of the Doucumentum software
• Searching the insurance detail (period, subscriber & dependant) with the help of Internet.
• Identify the correct insurance with card copy & also check for correct payer id which is needful for electronic billing
• Need to verify with the chart note previous encounters by clinic as we get help for process the claim.
• Working on quic software for tasking for need some info from other dept (attach ins, new ins)
Job Responsibilities: Payment Posting Dept.
• Working in Medical Billing Process (Patient Services, COB, FH Dept.)
• Working on client query’s which is very needful to correct maintain patient account
• Updating the COB info which is needful for secondary ins after the primary ins payment
• Working on Next Gen, Document Manager & CART Software.
• Working on different EOB with the help of insurance company update.
• Analyzing different eob & calculating the correct amt (paid, copay, co-ins & deductible) & send to pt or other ins.
• Analyzing the correct payment method (flat rate, case rate & capitation) as per contract.
• Searching the correct pt with DOS for post the payment in NG software.
• Creating the batch with correct deposit date for post the payment & maintaining pt’s A/C
• Working on Financial Hardship & SNCS which is for pt’s responsibly.
Achievement:
Get Promoted in special process & also awarded as Golden worrier Certificate for the Month of October'13, Nov’13,
Dec 13, and Apr’14 with IKS
Company : CALIBER POINT BUSINESS SOLUTIONS Ltd.
Designation : Specialist
Duration : Since April 09 to March 12
Achievement :
Awarded as Star Performer Certificate for the Month of October'07, May’08, Nov’08, Aug.10 & 11 with Caliber Point
Job Responsibilities:
• Working in Medical Billing Process (Ambulance Billing)
• Working on different clients with the help of process Rules.
• Working on Amazon Software for Ambulance Billing process (PCR & FS)
• Entering Patient Details With Insurance (Medicare, Medicaid & Commercial)
• Entering call details into Amazon Software for which service provided to Patient.
• Searching the mileage with the help of Internet.
• Identify the Service provided to patient (ALS & BLS)
• Identification of ICD Codes
• Entering the Charges entry for which service provided to the Patient.
• Query solving within the team member
• Auditing the Process.
Company : CALIBER POINT BUSINESS SOLUTIONS.
Designation : Service Delivery Executive.
Duration : Oct’06 to April 2009
Job Responsibilities:
• Working on Ultipro & Impromptu Software for Payroll Process.
• Unitime Process for Time Card Attendance Software
• Payroll starts with opening the payroll in the system, importing the data
Provided by the client, verifying the given data with the Extracted Pre-Check Detail Report,
• Entering Missing Punches or any Additional Working hours manually on the basis of information provided by Client
into Ultipro Software.
• Printing of Checks and direct deposit advices and generation of Invoices.
• Creation of NACHA File
• Monitor & Answer client calls and direct all emails to the concerned recipients
• Perform additional clerical function incidental to payroll department activities.
• Assisted with the entering of the New Hire data with the completion of forms such as Personal information, direct
deposit information, Employment eligibility information, Agreement forms.
• Assisted with the processing of Weekly, Bi-weekly, and Semi-monthly & Monthly payrolls.
• Auditing the Process.
• Generating the Invoices for Services Provided to Client (Draft Billing Detail Report )
Company : Shikovi Heatgen Technology Pvt. Ltd,.
Designation : Computer Operator
Duration : June 2005 to Dec. 2006
Responsibilities : Handling Accounting & Inventory Log
EDUCATIONAL QUALIFICATION:
Academic Year Year Board / University Class / Percentage %
S.S.C March-1999 Pune Board Second Class / 52 %
H.S.C. Feb-2001 Pune Board First Class / 69 %
T.Y.B.A March-2004 Pune University Second Class / 55 %
M.A. May-2006 Pune University Second Class / 53 %
ADDITIONAL QUALIFICATION :
• Computer knowledge of Windows 2007, DOS, (Word, Excel, PowerPoint & Internet,), Tally 5.4, 6.3 & 7.9.
• Computer Knowledge of DTP.
• English typing Speed of (40 W.P.M.)
INTERESTS :
Visiting to Forts, Playing Cricket etc
Personal Details :
Name : Sambhaji Hanumant Mohite
20th May 1984
Date of Birth :
Gender : Male
Marital Status : Married
Cast : Hindu - Maratha
National ity : I ndi an
Language Known : Marathi, Hindi & English
Tel. No. : 808-***-****, 842-***-****
Emai l Address : samshubh20509@gmai l.com
Date :
Place:
Sambhaji H. Mohite.
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