Accounts receivable management
RAJESWARI GOPINATH
Medical Biller
Carrollton,TX
Summary
Over 10 years of experience in end to end US Healthcare BPO - Medical billing offshore services in India for leading US Medical Billing companies and Healthcare Providers.
Started as a payment poster, a quick learner of end to end medical billing process, Handled several projects with various providers and specialties that includes Creating patient demographics Charge entry Quality Analysis Claim transmission Payment posting Denial Management Insurance follow-up and appeals Weekly/Monthly Report Generation, in various medical billing software both department wise and single Provider end-to-end.
Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors. Confident Medical Biller knowledgeable in data confidentiality and privacy practices when reviewing patient information.
Overview
10
10
years of professional experience
3
3
years of post-secondary education
Work History
Medical Billing Associate
SRF Infotel
Chennai, INDIA
03.2003 - 12.2003
- Prepared billing statements for patients and verified correct diagnostic coding.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Reviewed patient records, identified medical codes and created invoices for billing purposes.
- Adhered to established standards to safeguard patients' health information.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Gathered information from multiple sources to simplify billing and organize accounts.
- Managed billing calendar and scheduled claims for payments.
- Posted payments and collections on regular basis.
- Orchestrated medical coding, payment posting, accounts receivables and collections.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Prepared accounts with past due balances and transferred those cases to collection agency.
- Collected payments and applied to patient accounts.
- Posted surgical charges for practice providers.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Delivered timely and accurate charge submissions.
Medical Billing Specialist
Dpro technologies Pvt Ltd
Chennai, INDIA
09.2011 - 03.2012
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Reviewed patient records, identified medical codes and created invoices for billing purposes.
- Determined prior authorizations for medication and outpatient procedures.
- Located errors and promptly refiled rejected claims.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Prepared billing correspondence and maintained database to organize billing information.
- Maintained and updated collections tracking spreadsheet to help organize payment information.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Trained new employees on multiple medical billing programs and data entry software.
- Posted and adjusted payments from insurance companies.
- Responded to requests for information from various individuals by providing EOB documents from Primary to Secondary Insurance.
- Precisely evaluated and verified benefits and eligibility.
- Managed billing calendar and scheduled claims for payments.
- Set up and maintained new electronic billing system.
- Adhered to established standards to safeguard patients' health information.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Posted payments and collections on regular basis.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Liaised between patients, insurance companies and billing office.
- Gathered information from multiple sources to simplify billing and organize accounts.
- Delivered timely and accurate charge submissions.
- Collected payments and applied to patient accounts.
Medical Billing Specialist
Dprocessing Services Pvt. Ltd
Chennai, INDIA
02.2004 - 01.2007
- Dpro Technologies, a 6 year old offshore medical billing company providing end-to-end solutions located in Chennai, India, with proven expertise on all aspects of medical billing and collection services to medical billing companies in the USA and their US clients
- Reporting to Operations Manager, US Heathcare BPO
Medical Biller, Accounts Receivable
FlagshipMD India PVT LTD
Chennai, INDIA
12.2003 - 12.2004
- FlagShipMD provides Medical Billing service through its software named “FlagshipMD”
- This software provides Physicians, Practices, Billing Agencies and Transcription agencies a complete, secure, integrated, and easy-to-use practice management system
- Healthcare Reporting to Accounts Manager, in US Provider office
- Specialties Handling: OB-GYN, Family Practice and Infectious Disease.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Orchestrated medical coding, payment posting, accounts receivables and collections.
- Adhered to established standards to safeguard patients' health information.
- Posted payments and collections on regular basis.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Trained new employees on multiple medical billing programs and data entry software.
- Managed billing calendar and scheduled claims for payments.
- Prepared accounts with past due balances and transferred those cases to collection agency.
Senior Medical Biller
M/s. Verimed Services Pvt Ltd
Chennai, INDIA
09.2000 - 09.2002
- Reporting to Team leader
- Specialties, Charge Entry, Cash Posting and Analysis
- Verimed Services P Ltd is the Indian arm of M/s Verimed Services Inc, USA, which caters to the needs of the US Healthcare Industry
- Specialties handled : Ambulatory Surgery, Anesthesia, Cardiology and Cardiovascular Surgery
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Reviewed patient records, identified medical codes and created invoices for billing purposes.
- Trained new employees on multiple medical billing programs and data entry software.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Delivered timely and accurate charge submissions.
- Prepared accounts with past due balances and transferred those cases to collection agency.
- Adhered to established standards to safeguard patients' health information.
- Gathered information from multiple sources to simplify billing and organize accounts.
- Posted payments and collections on regular basis.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Managed billing calendar and scheduled claims for payments.
Payment Poster - MEDICAL BILLING
M/s. Nittany Decision Services Pvt. Ltd
Chennai, INDIA
01.1998 - 09.2000
- Nittany functions as an offshore processing unit doing Medical Billing services for hospitals and physicians based in the US
- Medical Billing is a concept, which was introduced to India by Nittany
- Its office located at chennai is a third party Service Corporate Center and was headquartered at State College, Pennsylvania, USA
- Specialties handled : General Medicine, Pulmonary Medicine, Internal Medicine, Orthopedics, Critical care & General Practice.
- Accurately posted payments and adjustments both electronically and manually.
- Managed large volumes of data efficiently and with great care on daily basis.
- Reconciled accounts receivable ledger to verify payments and resolve variances.
- Processed payments that had been received from insurance companies and Medicare.
Education
Bachelor of Science - Mathematics
Meenakshi College For Women
CHENNAI - INDIA 06.1994 - 04.1997
Skills
Data analysis
Payment posting
Patient account analysis
Quality Assurance Management
Software
Medic
Medical manager
Prime Clinical
Hipocrates III
Additional Information
Open for Contract W2/C2C, Part-time/Full-time.
Eligible to work for any employer.
Timeline
Medical Billing Specialist
Dpro technologies Pvt Ltd
09.2011 - 03.2012
Medical Billing Specialist
Dprocessing Services Pvt. Ltd
02.2004 - 01.2007
Medical Biller, Accounts Receivable
FlagshipMD India PVT LTD
12.2003 - 12.2004
Medical Billing Associate
SRF Infotel
03.2003 - 12.2003
Senior Medical Biller
M/s. Verimed Services Pvt Ltd
09.2000 - 09.2002
Payment Poster - MEDICAL BILLING
M/s. Nittany Decision Services Pvt. Ltd
01.1998 - 09.2000
Bachelor of Science - Mathematics
Meenakshi College For Women
06.1994 - 04.1997
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