M NOUMAN RAMZAN

🔹 Leadership & Team Management

Supervise and guide a team of medical billers and coders.

Assign tasks and ensure timely completion of billing processes.

Provide training, coaching, and performance evaluations for billing staff.

Resolve team conflicts and support a positive work environment.

🔹 Billing Oversight

Oversee the entire medical billing process from charge entry to final
payment.

Ensure claims are submitted accurately and timely to insurance companies.

Monitor denials and rejections; implement processes to reduce them.

Ensure proper follow-up on unpaid or underpaid claims.

🔹 Compliance & Accuracy

Ensure billing practices comply with federal and state regulations (e.g., HIPAA).

Maintain accuracy in patient data, billing codes (CPT, ICD-10), and insurance information.

Stay updated on industry changes in coding and reimbursement rules.

🔹 Reporting & Analytics

Generate and analyze billing and collection reports.

Track KPIs such as Days in A/R, claim denial rates, and collection rates.

Identify trends or issues and recommend improvements.

🔹 Cross-Department Coordination

Collaborate with front office, coding, and collections teams.

Communicate with providers, payers, and patients to resolve complex billing issues.

Work with IT to optimize billing software and tools.

🔹 Process Improvement

Develop and update SOPs (Standard Operating Procedures).

Streamline billing workflows for efficiency and accuracy.

🔹 Insurance A/R Follow-Up
Track and follow up on unpaid or partially paid claims with insurance companies.

Call or email insurance payers to check claim status.

Resubmit or correct denied/rejected claims based on payer feedback.

🔹 Denial Management
Review Explanation of Benefits (EOBs) or Electronic Remittance Advices (ERAs) for denials or underpayments.

Identify reasons for claim denials (e.g., coding errors, eligibility issues, timely filing).

Work with the billing/coding team to resolve and appeal denied claims.

🔹 Payment Reconciliation
Match payments received to billed amounts.

Post payments accurately in the billing system.

Record adjustments, write-offs, and refunds appropriately.

🔹 Patient A/R Follow-Up (if applicable)
Contact patients for outstanding balances after insurance payment.

Set up and monitor patient payment plans.

Answer billing-related questions from patients courteously and accurately.

🔹 A/R Reporting
Generate aging reports (30/60/90+ days) to track outstanding receivables.

Maintain daily productivity logs and A/R worklists.

Provide weekly/monthly reports to team leads or managers.

🔹 Compliance & Documentation
Ensure adherence to HIPAA, company policies, and payer-specific rules.

Maintain accurate and detailed notes on all follow-ups and communications.

Stay current on payer updates, claim filing timelines, and A/R best practices.

🔹 Cross-Department Collaboration
Work closely with coding, billing, and payment posting teams.

Coordinate with providers or front desk staff to obtain missing information or documentation.

• 🔹 Claim Preparation & Submission
  Accurately prepare and submit medical claims to insurance companies (private, Medicare, Medicaid).
  
  Use correct CPT, ICD-10, and HCPCS codes based on documentation and coding guidelines.
  
  Verify patient insurance coverage and authorization requirements before billing.
  
  🔹 Patient Billing
  Generate and send patient statements for balances due.
  
  Respond to patient inquiries about billing and insurance.
  
  Set up payment plans when necessary.
  
  🔹 Compliance & Accuracy
  Ensure compliance with HIPAA and healthcare billing regulations.
  
  Maintain accuracy in patient demographics, insurance data, and billing codes.
  
  Keep up-to-date with payer guidelines and industry changes.
  
  🔹 Documentation & Reporting
  Maintain accurate billing records and audit trails.
  
  Generate daily, weekly, or monthly billing reports.
  
  Assist in preparing data for audits and internal reviews.
  
  🔹 Software & Tools
  Use Electronic Health Record (EHR) and Practice Management systems.
  
  Handle data entry, batch processing, and claim status tracking tools.