Medical Biller Surgery Scheduler

Purvi .Y. Mehta Cell: 331-***-****

*** ******* *****, ** *******, IL -60174. ******@*****.***

CAREER OBJECTIVE

To obtain a career in the medical industry as a Biller and as a person who likes to take the challenges given by the insurance company regarding the claims and payments.

PERSONALITY PROFILE

Strong analytical skill and problem solving skill.

Excellent negotiations skill, handling of more complex billing issues which are typically multi-functional and affecting a large volume business.

Quick learner who adapts to the tools available to successfully accomplish tasks.

Strong knowledge of ICD 10 and ICD9 and CPT code

WORK EXPERIENCE

November 2018- Current

Billing Specialist [Amita Medical Group in Bartlett, IL 60103]

April 2016 – Current November 2018

Medical Biller [Suburban Neurology in Geneva, IL 60134]

June2015- April 2016

AR Consultant at GI office in Addison

November 2014 - June 2015

Medical Biller [Midwest Pediatrics Cardiologist in Hoffman Estates, IL 60169]

November 2012- November 2014

Medical Biller [Hoffman Estates Surgery Center in Hoffman Estates, IL 60169]

March 2010- November 2012

Office Coordinator [GI Office in Addison, IL 60101]

June 2005 – May 2009

Medical Biller [OB /GYN Office in Geneva, IL 60134]

RESPONSIBILITY

Patient’s accounts, Billing and Collection Specialist and Surgery Scheduler, Office staff scheduling, Inventory.

Responsible for the office schedule to be more productive, also responsible for the doctor surgeries to be properly scheduled with the hospital and the surgery center.

Worked with insurance companies such as Medicare, Medicaid, and Blue Cross Blue shield Insurance and

other commercial Insurances.

Set-up payment plans for patients and collections.

Working with Insurance collections and patient collections.

Obtain eligibility, benefits, precertification, and authorization in a timely manner.

Responsible for the claims to billed in timely manner and my performance report for the practice was less than a 1 day and was responsible to reduce A/R to the almost 85%.

Responsible to Organize and coordinate the activities and flow billing and collection function and assist patient with meeting their financial obligation by providing education regarding copay, coinsurance,deductible and related matters.

Help the management and was actively involved in improvement of the practice rating to one of the top with patients satisfaction.

Backup for the referral department in obtaining the referral for the patient in a timely manner.

Involved in helping the provider with claim audits and was a second eye for the provider to make sure the claim was billed correctly with proper level and with correct modifier.

Proactively analyze account activity, identifies problems and initiates appropriate action.

Actively involved in procedures and suggestions for process improvements within the department. Monitors registration including insurance verification to ensure processing within the quality standards and adjusted the process as needed to meet the standards.

Completed the task and other duties assigned by the manager.

Communicated with both internal and external department concerning the credentialing issues regarding insurance verification. Remained current on specific changes related to various insurance carrier.

Maintained adequate documentation for analysis regarding billing department.

Worked as a liaison between business and practice staff on a need to basis.

Generates HCFA 1500 statements and electronic bills for account balances. Posts insurance payments received for each patient. Posting patient and insurance cash payments.

File electronic and paper claims to insurance companies

Follow-up on patient/insurance claims for patient, insurance, and government payors.

Conduct follow-up with insurance companies on denied and rejected claims

Customer service - handles more complex phone calls received. Helps with outgoing calls to patients, insurance carriers and clients when difficult situations arise.

Secondarily, communicate with patients regarding outstanding balance and timely pay-off of account

Working on Aging reports on a monthly basis. Reconciling patient and clients’ accounts by aging reports.

ACHIEVEMENTS:

I have reduced the insurance outstanding more the 75% and patient outstanding by 50%.

Every month generated a aging report to see which claims were not paid, worked on those claims by calling the insurance company to see where the problem was corrected it . By generating this report, following the pattern reduced the insurance outstanding. The same method was used for patients outstanding.

Difficult surgery cases, multiple surgery case done by the doctor were not properly paid by the insurance company or denied was appealed and in the process the insurance company had to pay the provider.

Negotiate with the insurance company regarding the fee schedules, and every year get a new negotiated fee reimbursement.

Entered the daily claims, hospital claims in the computer. When payment was received from the insurance company verified whether the reimbursement was correct and entered the amount respective patient’s account.

Resolving Return-To-Provider issues and Explanation of Benefit denials in a timely manner.

Managing Insurance responsibility A/R including: Following up on unpaid claims

on a monthly basis, notating response on patient account, updating accounts

with corrected information, rebilling regenerating claims or providing

insurance company with necessary documentation to facilitate payment.

Managing patient responsibility A/R including Establishment and monitoring of

payment plans from responsibly parties, sending monthly patient statements,

determining appropriate write offs.

Upgraded the office software to Intergry and maintained the System like a system manager.

EDUCATION:

2005-2006

Certified Medical Biller

Elgin community college

1995-1997

Master’s in Business Administration

University of Madras

Madras, India

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