Muhammad Adeel ADEEL

- Supervise complete end-to-end RCM operations, ensuring seamless workflows from patient scheduling, eligibility verification, prior authorizations, charge entry, payment posting, AR follow-up to denial resolution. - Lead Credentialing and Re-credentialing for providers across multiple US states, including state medical licenses, DEA registration, PECOS, CAQH, and NPI management. - Direct client relations across multiple specialties, providing expertise on payer guidelines, documentation requirements, and revenue improvement strategies. - Oversee eligibility and benefits verification processes, securing accurate coverage details for commercial and government payers. - Plan and implement quality assurance for all RCM processes to improve first-pass claim acceptance and reduce AR days. - Analyze AR trends, rejection patterns, and denial reasons to implement proactive solutions and optimize revenue. - Address complex payer escalations and provider issues related to claims processing, credentialing delays, or compliance concerns.

- Oversaw operations covering verification of benefits, authorizations, charge entry, rejections handling, AR follow-ups, and denial appeals. - Managed provider credentialing and multi-state licensing renewals, ensuring providers’ eligibility for billing across varied insurance panels. - Acted as liaison between healthcare providers and payers to resolve claim disputes and credentialing issues swiftly. - Conducted in-depth training for staff on the full RCM cycle, credentialing standards, and regulatory updates.

- Led a team managing front-to-end billing processes: patient scheduling, insurance verification, authorizations, charge posting, payment posting, AR recovery, and denial management. - Administered credentialing and CAQH maintenance, coordinated with payers for provider enrollment and re-enrollment. - Worked with payers (Medicare, Medicaid, Commercial) to reduce outstanding AR and enhance claims acceptance rates. - Provided hands-on support in complex accounts and payer negotiations.

- Managed comprehensive medical billing processes including charge entry, payment posting, AR follow-up, and appeals for denials and rejections. - Supported credentialing, CAQH updates, NPI registrations, and enrollment with multiple payers. - Handled insurance verification, prior authorization processes, and scheduling coordination with front office teams. - Maintained close relationships with providers to ensure operational transparency and regulatory compliance.