Certified Medical Insurance Specialist, Medical Credentialing, Revenue Cycle, Medical Biller & Coder, Referral, Authorization Expert
Fresno,TX
Summary
Fresno, TX
Successful at efficiently handling client inquiries, billing and administrative tasks. Expert with contracts and other documents affecting billing processes. Prepares professional, polished statements and business correspondence. To be a part of a team-oriented company, which will allow me to utilize interpersonal knowledge and skills in the Management and Medical billing, coding, authorization, referrals, credentialing and contract with insurance/hospital.
Authorized to work in the US for any employer
Overview
20
20
years of professional experience
Work History
Billing and Credentialing Manager
KOTA JAGDISH REDDY MD. PA
Sugar Land, TX
07.2005 - 03.2020
To maintain proper billing practices and medical procedures to meet current protocol and guidelines
within the Government and Commercial insurance field.
Credentialing and enrolling new physicians into the medical practice and insurance field.
Credential and Enroll practicing physicians into the Medicare and Medicaid insurance field.
Credential and Enroll practicing physicians into the commercial insurance sector field.
Credential and Enroll practicing physicians to new commercial insurance providers.
Update yearly credentialing certificates for practicing physicians.
Schedule yearly and quarterly credentialing testing reviews for practicing physicians.
Coordinate and implement present and future Medicaid and Medicare structured guidelines.
Coordinate and implement present and future private insurance carriers' guidelines.
Structured, Develop and implement new office procedures and practices.
Handling company's' billing inquiries and processing procedure.
Handling Patient's' billing inquiries and processing procedure.
EON'S posting payments, Patient accounts and Patients analyst.
Managing Patients billing, Procedures, Verification, Referrals, authorization and approval.
Experience with Primary practice, Interventional Cardiology, Cardiology, Gastroenterology billing;
Credentialing and management with Revenue cycle.
EMR- E-Clinical Works, Medisoft, Health pack, Advance MD, Epic.
Medical Certification - Certified Medical Insurance Specialist.
Office Manager/Executive Assistant
Community Medical Clinic
Houston, TX
06.2002 - 06.2005
Hired as an Operational Management to increase internal and external business development within its'
related medical practices and procedures.
Increased financial and business standing within the profession.
Improved market shares and business recognition.
Improved community and customer awareness.
Structured, Develop and implement new office procedures and practices.
Affiliated medical suppliers and drug reps to the organization.
Collaborated with T.D.H.
(Texas Department Of Health) for child vaccine program.
Re structured internal and external business and service image.
Coordinated, Corresponded and participated in community medical clinical pilot projects.
Structuring Providers weekly schedules to meet medical operational hours.
Presenting monthly internal and external reports to B.O.D.
(Board Of Directors.).
Structuring associates
payroll and work schedules.
Resolving patients and clients concerns and situations.
Introduction, development and implementation of New Dentistry sector within practice.
Implementation and coordination of dentistry supplier and product to practice.
Coordinating and implementing future Medicaid and Medicare structured guideline acceptance.
Responsibility of co-coordinating, organization and marketing for all outreach programs
& health fairs.
Consultant
Renal Care Group Southwest Houston Nephrology & Hypertension Clinic
Houston, TX
02.2002 - 09.2002
For the purpose of restructuring the office.
Develop and implement new business procedures and office
operation.
Improved financial and business standing within the profession.
Increased market share and business recognition.
Implemented the procedure of verification of the patient eligibility and benefits.
Established Doctor's contractual agreement with all the major insurance organization.
Organized patients folder.
Scheduling appointments, Procedures, Verification, Referrals and Appeals.
Increase business efficiency and performance.
Computer dexterity.
Cleared the patient billing.
Office and Billing Manager
Houston Gastroenterology
Houston, TX
07.2000 - 11.2001
Hired for the purpose of restructuring and managing billing procedure, maintenance of office organization
and operation.
Billing recovery and reconciliation practices.
Handling company's' billing inquiries and processing procedure.
Handling Patient's' billing inquiries and processing procedure.