Billing Department Medical Office

SKILLS

PROFESSIONAL SUMMARY

WORK HISTORY

ELHAM ASALI

240-***-**** • **********@*****.***• Lake In The Hills, IL 60651 Committed, responsible, and organized Medical Biller and Coder with more than16 years of experience in interacting with staff, patients, and insurance companies. Hardworking, educated, and willing to go extra mile to complete tasks. Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts, and reviewing health records to identify proper diagnosis codes for billing. Analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payments.

Competence in CPT Coding and

Modifiers,ICD10-CM, HCPCS and

PCS / Outpatient and Inpatient

Coding

Knowledge of Insurance Rules and

Regulations

Medical Billing Processing

Past Due Balance Management

Competence in Medical

Terminology,Anatomy, Physiology

and Pharmacology

Complex Problem-Solving

Teamwork

Active and Fast Learning

Familiarity with HIPPA and

Medical Release of Information ROI

Time Management

Accuracy and Attention to Details

Excellent Communication Ability

Sep 2022 - Current

Crystal Lake, IL

Director of Billing Operation / Northern Illinois Foot & Ankle Specalists Managing onsite billing department employees and outsourced billing department team members in Philippine. (Hello-Rache Virtual Assistant) Managing coding and billing of charges for 13 locations and 22 active doctors.

Implementing new processes and procedures in billing department resulting in significant decrease in overdue claims and 85% increase in timely payment rates.

Improving billing operations by analyzing data and identifying areas for improvement.

Direct training and management of new Billing Department staff. Supervising of Revenue Cycle Management and Account receivable. Interacting with physicians and other healthcare staff to train and make them up to date with insurances policies and coding guidelines by publishing Billing Bulletin bi-weekly.

Assisting in resolving unpaid claims and denials.

Maintaining NextGen EHR File Maintenance, updating new CPT codes, Fee schedules and ... as needed.

Acquiring up-to-date knowledge of coding and billing requirements through continuing education courses and certification renewal Jan 2019 - Sep 2022

Chicago, United States

Medical Coding and Billing Specialist / Talcott Foot And Ankle Specialist Increased rate of sending clean claims out by 97% to third party payers Interacted with physicians and other healthcare staff to ask questions regarding patient services. Checked ICD10-CM, CPT, HCPCS codes to prevent using unbundled codes

Added appropriate modifiers to CPT codes for improved reimbursement Reviewed outpatient records and documents to identify diagnoses and procedures

Identified reasons for rejected claims and correcting and resubmitting them Processed insurance company denials by auditing patient files, searching procedures and diagnostic codes again to determine proper reimbursement Posted payments and sending bills to patients

Performed billing and coding procedures for inpatient and outpatient services

Obtained Authorization for Sx, Orthotics, Diabetic Shoes, MRI, etc. Checked eligibility and benefits through Ins. web portals or phone calls to Insurance Companies

Supervised receptionists and data entry processing Aug 2010 - Apr 2013 Admission and Medical Records Depatment Manager / Jam Hospital Invited to Jam Hospital to improve and upgrade Its Admission and Medical Records Department to prepare it for hospital Accreditation Facilitated hospital to obtain highest grade of accreditation in the same year Direct day-to-day administrative and operational functions for 300-bed facility, providing guidance and leadership to over 30 employees and received daily direct reports from more than 5 departments Analyzed quality control assessment findings and developed and implemented methods to improve performance (Clinical Governance) Created and maintained safeguards against unauthorized access and use of computer-based medical records

Abstracted information from records as authorized or requested by insurance companies and other third-party payers

Successfully negotiated client contract renewals to create increased revenue Secretary of Mortality and Morbidity Committee

Director of Health Information Committee

Member of Root Cause Analysis (RCA) Committee

Jan 2006 - Nov 2010 Health Information Specialist / Parsian Hospital Initiated MR system in collaboration with MR Manager at time of hospital opening

Interacted with physicians and other healthcare staff to ask questions regarding patient services

Reviewed, analyzed and managed coding of diagnostic and treatment EDUCATION

CERTIFICATIONS

procedures contained in outpatient and inpatient medical records Resourcefully used various coding books (ICD10, PCS, HCPCS, CPT) and on-line encoders

Initiated, performed, and documented quarterly coding audits for physicians Jan 2002 - Jan 2005 Medical Billing Clerk / Jam E Jam Imaging Center Prepared billing statements for patients and verified correct diagnostic coding

Communicated with insurance providers to resolve denied claims and resubmitted them

Collected payments and applied to patient accounts Posted payments and collections on regular basis

Managed billing calendar and scheduled claims for payments May 2022

River Grove, IL

School of Continuing Education in Medical Billing And Coding Triton College

Aug 2008

Tehran-Iran

Master of Science in Health Information Informatics Tehran University of Medical Science

Jun 2005

Tehran-Iran

Bachelor of Science in Health Information Management Tehran University of Medical Science

CBCS - Certified Billing and Coding Specialist 2022 NHA - National Healthcare's Association 2022

Crisis Management 2012

Balanced Strategy Management 2012

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