Madhurama Sharma

ad44l9@r.postjobfree.com

Cell : 201-***-****

Professional Summary

Over 8 years of experience across Medical practice management, Billing, Analyzing Claims, pursuing a role where hard work and dedication will be highly valued.

Experience in working with Insurance providers, Clients,Third party Negotiators, Law offices.

Specialties: HIPAA, EHR/EMR, CPT, ICD-9, ICD-10, EDI, Medical Claims, Medical Coding, Insurance Credentialing, Handling Negotiations.

Technical Skills: Word, Excel, PowerPoint, Outlook, EMR - Eclinical works, Epic, NextGen.

Skills: Analytical thinking, Excellent Written and Verbal Communication skills, Problem Solver, Detail-Oriented.

Education/Certifications

CBCS Certificate NHA (2017) in Medical Coding & Billing

Purdue University, USA

Post Graduate Program in Business Analysis (2022)

Certified Business Analysis Professional (2022)

Punjab University, India

Masters in Commerce –Accounting (Major) (2002)

Experience

June 2021 – Present Claims Analyst and Biller, Xenon Health- Jersey City, NJ

Coding, Reviewing, analyzing, investigating and processing a high volume of medical anesthesia claims (125-130 claims per week) in accordance with accounting principles and legal guidelines; Comprehensive understanding of the laws and guidelines concerning medical claims, and fully compliant with HIPPA regulations.

Worked on claims for multiple specialties – Pain Management, GI cases, Urology, Occular, ENT as well as Worker’s Compensation claims across USA.

Credentialing new providers with insurances.

Running and generating Accounts receivable and profit and loss statement and analyzing various reports and presenting analysis results in Team meetings and working towards resolving any issues.

Negotiating with Third Party Pricer's like Multiplan, Dataisight, Zellis for full payment on claims.

Mentoring and training new hires over all aspects of claims processing from coding until the claims are paid and working on denials and rejections.

Effectively corresponded with Insurance Carriers, Clients, Customers and Administrators.

Focus on Accuracy and Timeliness to prioritize efficiency.

Handled escalated irate calls and made sure their needs were being met from a supervisory perspective.

March 2017 – June 2021 Practice Manager and Billing Supervisor, Prevention First Primary Care, NJ

Getting Prior Authorizations and Referrals through programs such as Evicore and Navinet.

Creating and Updating Patient’s chart in Electronic Health Records.

Medical records management and upkeep.

Employee Timecards administration.

Answering patients’ billing questions online, mail & phone.

Work daily and monthly financial reports.

Evaluation of practice’s Medical Coding & Billing procedures with an aim towards maximizing revenues and preventing revenue losses

Recruitment and training of medical and non-medical staff

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