Ibtisam Shaikh

● Maintained and prioritized to-do lists and followed up to complete tasks on-time.

● Resolve rebilled claims for a variety of hospital clients and healthcare systems by utilizing internal R1 programs and the client’s health information systems.
● Monitor accounts for payment and correctly calculate net reimbursement to add to the monthly invoice.
● Verify that the revised UB-04 claim coding corrections were released correctly on a hospital inpatient/outpatient bill to obtain accurate reimbursement from the insurance.

• Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
• Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
• Submitting insurance claims and following up on unpaid, rejected, or denied claims to maximize revenue recovery.
• Communicated effectively and extensively with other departments to resolve claims issues.
• Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
• Presenting insightful reports to my supervisor for actionable recommendations.
• Managing the process of patients paying for medical services directly, without insurance, including tasks like billing, payment arrangements, and collections.

• Conducted detailed financial analysis to identify and evaluate changes in operations, trends and potential areas of improvement.

● Conduct financial analysis to improve claims processing, reimbursement accuracy, and revenue cycle operations.
● Utilize Epic for coding verification, claims categorization, and insurance payment tracking.
● Managed billing disputes, composed appeal letters, and resubmitted denied claims to maximize revenue recovery.
● Assist in training and process improvement projects to streamline financial operations.
● Support Epic system upgrades and go-live implementations to optimize system performance.

● Worked with the software development team on
reported errors and bugs on newly released software and assisted in the deployment of release fixes.

● Assisted with Epic upgrade before and after go-live
acceptance to deliver well-tested enhancements and
meet business requirements.