Elham Asali
Lake In The Hills,IL
Summary
Dynamic leader and certified medical billing and coding professional with over 18 years of experience in the healthcare sector. Proven track record in managing teams of up to 30 direct reports, including supervisors and coordinators. Expertise in auditing, managing work queues, developing training programs, and implementing new processes and protocols.
Successfully streamlined operations at Northern Illinois Foot & Ankle Specialists, resulting in an 85% increase in timely payments. Highly skilled in CPT coding and modifiers, with a reputation for exceptional problem-solving abilities. Strong project management and decision-making skills, adept at coordinating production plans and personnel resources to meet tight deadlines.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Director of Medical Billing Operation
Northern Illinois Foot & Ankle Specalists
Crystal Lake, IL
09.2022 - Current
- Managing and oversee onsite billing department employees and outsourced billing department team members in Philippine. (Hello-Rache and My Mountain Mover Virtual Assistant)
- Managing coding and billing of charges for 15 locations and 23 active doctors.
- Implementing new processes and procedures in billing department resulting in significant decrease in overdue claims and 85% increase in timely payment rates.
- Improving billing operations by analyzing data and identifying areas for improvement.
- Hiring and Direct training and management of new Billing Department staff.
- Supervising of the whole Revenue Cycle Management and Account receivable.
- Interacting with physicians and other healthcare staff to train and make them up to date with insurances policies and coding guidelines by publishing Billing Bulletin bi-weekly.
- Assisting in resolving unpaid claims and denials.
- Maintaining NextGen EHR File Maintenance, updating new CPT codes, Fee schedules and ... as needed.
- Acquiring up-to-date knowledge of coding and billing requirements through continuing education courses and certification renewal.
- Revising all the Operative report and coding properly based on CPT and ICD10CM.
- Revamping company protocols and successfully implementing them organization-wide, identifying and resolving potential errors and issues along the way.
Medical Coding and Billing Manager/ Office Manager
Talcott Foot And Ankle Specialist
Chicago, United States
10.2018 - 09.2022
- Increased rate of sending clean claims out by 97% to third party payers
- Interacted with physicians and other healthcare staff to ask questions regarding patient services. Checked ICD10-CM, CPT, HCPCS codes to prevent using unbundled codes
- Added appropriate modifiers to CPT codes for improved reimbursement
- Reviewed outpatient records and documents to identify diagnoses and procedures
- Identified reasons for rejected claims and correcting and resubmitting them
- Processed insurance company denials by auditing patient files, searching procedures and diagnostic codes again to determine proper reimbursement
- Posted payments and sending bills to patients
- Performed billing and coding procedures for inpatient and outpatient services
- Obtained Authorization for Surgeries, Orthotics, Diabetic Shoes, MRI, etc.
- Checked eligibility and benefits through Ins. web portals or phone calls to Insurance Companies
- Supervised receptionists and data entry processing
- Managed office inventory and order medical supplies and equipments.
- Scheduled the staff on the weekly basis.
Admission and Medical Records Depatment Manager
Jam Hospital
Iran-Tehran
08.2010 - 04.2013
- Invited to Jam Hospital to improve and upgrade Its Admission and Medical Records Department to prepare it for hospital Accreditation
- Facilitated hospital to obtain highest grade of accreditation in the same year
- Direct day-to-day administrative and operational functions for 300-bed facility, providing guidance and leadership to over 30 employees and received daily direct reports from more than 5 departments
- Analyzed quality control assessment findings and developed and implemented methods to improve performance (Clinical Governance)
- Created and maintained safeguards against unauthorized access and use of computer-based medical records
- Abstracted information from records as authorized or requested by insurance companies and other third-party payers
- Successfully negotiated client contract renewals to create increased revenue
- Secretary of Mortality and Morbidity Committee
- Director of Health Information Committee
- Member of Root Cause Analysis (RCA) Committee
Health Information Specialist
Parsian Hospital
01.2006 - 11.2010
- Initiated MR system in collaboration with MR Manager at time of hospital opening
- Interacted with physicians and other healthcare staff to ask questions regarding patient services
- Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient and inpatient medical records
- Resourcefully used various coding books (ICD10, PCS, HCPCS, CPT) and on-line encoders
- Initiated, performed, and documented quarterly coding audits for physicians
Medical Billing Clerk
Jam E Jam Imaging Center
01.2002 - 01.2005
- Prepared billing statements for patients and verified correct diagnostic coding
- Communicated with insurance providers to resolve denied claims and resubmitted them
- Collected payments and applied to patient accounts
- Posted payments and collections on regular basis
- Managed billing calendar and scheduled claims for payments
Education
School of Continuing Education - Medical Billing And Coding
Triton College
River Grove, IL05.2022
Master of Science - Health Information Informatics
Tehran University of Medical Science
Tehran-Iran08.2008
Bachelor of Science - Health Information Management
Tehran University of Medical Science
Tehran-Iran06.2005
Skills
- Revenue Cycle Management: Proficient in optimizing processes for improved financial performance
- Medical Coding Expertise: Skilled in CPT coding, modifiers, ICD-10-CM, HCPCS, and PCS for both outpatient and inpatient settings
- Insurance Knowledge: In-depth understanding of insurance rules and regulations
- Software Proficiency: Familiar with Microsoft Office, Epic, NextGen, GreenWay and Compulink
- Medical Terminology Proficiency: Strong foundation in medical terminology, anatomy, physiology, and pharmacology
- Complex Problem-Solving: Adept at analyzing and resolving intricate issues efficiently
- Quick Learner: Demonstrates the ability to rapidly assimilate new information and skills
- HIPAA Compliance: Familiar with HIPAA regulations and medical release of information (ROI) processes
- Time Management: Effective in prioritizing tasks to meet deadlines
- Attention to Detail: Committed to accuracy in all aspects of work
- Communication Skills: Excellent verbal and written communication abilities
Certification
- CBCS - Certified Billing and Coding Specialist 2022
- NHA - National Healthcare's Association 2022
- Crisis Management 2012
- Balanced Strategy Management 2012
Timeline
Director of Medical Billing Operation
Northern Illinois Foot & Ankle Specalists
09.2022 - Current
Medical Coding and Billing Manager/ Office Manager
Talcott Foot And Ankle Specialist
10.2018 - 09.2022
Admission and Medical Records Depatment Manager
Jam Hospital
08.2010 - 04.2013
Health Information Specialist
Parsian Hospital
01.2006 - 11.2010
Medical Billing Clerk
Jam E Jam Imaging Center
01.2002 - 01.2005
School of Continuing Education - Medical Billing And Coding
Triton College
Master of Science - Health Information Informatics
Tehran University of Medical Science
Bachelor of Science - Health Information Management
Tehran University of Medical Science