Medical Billing Revenue Cycle
Resume:
CURRICULUM VITAE
MOHAMMED BASHEER BASHA
Dunlop Nagar, Vepampattu,
Thriuvallur 602024
Cell : 91+994*******
Email:**************@*****.***
INTRODUCTION
Embark on a journey to explore the intricacies of the AR Caller role and gain insights into the responsibilities, requirements, and skills that define this crucial position in the healthcare industry.
CAREERS SUMMARY
High energy and highly motivated professional with 14 years of experience in Denial management, Insurance Verification, AR account receivable and RCM revenue cycle management exceptional management skills, interpersonal skills and collaborative team skills with a comprehensive background knowledge of US medical billing terminology medical claims, us insurance
Good knowledge about US healthcare insurance plans, appeal, denails remarks codes SKILLS
Billing knowledge Insurance Verification
Denial management
Account Receivable Follow up Account Payable
Problem solving Strong communication
Ability to work for long hours Good knowledge in epic software MS office
Typing skills
AR CALLER JOB DESCRIPTION
Uncover the key aspects of the AR Caller job role and how it contributes to the seamless functioning of healthcare revenue cycle.
JOB BRIEF
The AR Caller, or Account Receivable Caller, plays a vital role in the healthcare revenue cycle.
Responsible for contacting insurance companies and patients to follow up on outstanding medical claims.
Navigates complex billing and coding processes to ensure accurate reimbursement for healthcare services.
RESPONSIBILITIES
Initiate calls to insurance companies for claim resolution and follow-up. Address patient inquiries regarding billing issues and provide clear explanations. Collaborates with internal teams to resolve discrepancies and expedite claims processing.
Maintain details records of interactions and claim status for accurate reporting.
Adhere to industry regulations and compliance standards in all communication and document reporting.
Excellent written and verbal communication skills. Outstanding problem-solving and organizational abilities.
Preparing and submitting billing data and medical claims to insurance companies.
Investigating and appealing denied claims.
Examining patient bills for accuracy and requesting any missing information. EDUCATION:
Year 2000-2003 - The New College Bachelors Of Arts Madras University
( Specialzation Accounting)
Year 1996 - Higher Secondary School Level Certification
Year 1993 - Secondary School Level Certification EXPERIENCE
February 2024 till present Working as a process associate level 2 in ags healthcare
March 2010 to till January 2024 worked as a Senior Account Executive in Coronis Ajuba Healthcare (Formely know as Miramed Ajuba Global Service Company )
December 2008-March 2010 Worked as an Executive Account Receivable in Dell Perot System Chennai.
JOBS AND RESPONBILITES:
Miramed Ajuba Global Service company service:
Obtaining referrals and pre authorizations as required for procedures.
Checking eligibility verification for rebill the claim to Insurance company.
Reviewing patient bills for accuracy and completeness, and obtaining any missing information.
Preparing, reviewing, and transmitting claims using billing software,including electronic and paper claim processing.
Following up on unpaid claims with in standard billing cycle timeframe.
Checking each insurance payment for accuracy and compliance with contract discount.
Calling insurance companies regarding any discrepancy in payments if necessary.
Identifying and billing secondary or tertiary insurance.
Reviewing accounts for insurance follow – up .
Researching and appealing denied claims.
Answering all insurance telephone inquiries pertaining to assigned accounts. Dell Perot System:
Responsibilities for processing payments,adjustment and denials according to established guidelines.
Review medical records documentation to identify services provided by physicians and mid-level providers as it pertains to claims that are being filed.
Ensure accurate entry of work into designated billing systems.
Assist with training materials and training staff members.
Communicates with the insurance agents to provide or obtain corrected or additional data.
Rejections for working EDI claims rejections in a timely manner.
Successfully works as a team member.
Identifies procedures code, add on code, history code and principle,diagnosis performed on each patient and properly codes each procedure.
Works claims and claim denials to ensure maximum reimbursement for services provided.
Works directly with insurance companies to get claims processed and paid.
Working knowledge of basic computer functions, with an emphasis on typing. Working knowledge of basic math including percentages DECLARATION :
I here by declare that all the information given by me is correct to the best of my knowledge.
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