Nisha Deepthi Perumalla
Chicago,IL
Summary
Detail-oriented Auditor and Medical Billing Specialist with over 9 years of experience, skilled in claims adjudication, training, and process improvement. Expertise in eligibility verification, authorization denials, EMR updates, and HIPAA-compliant billing workflows. Drives value through cross-department collaboration and SOP updates, supporting diverse claims across inpatient, outpatient, urgent care, physical therapy, DME, anesthesia, radiology, and lab services.
Overview
10
10
years of professional experience
Work History
Medical Billing Specialist
Outsource Receivables.inc
mounds view, MN
08.2024 - Current
- Followed up on unpaid claims with insurance carriers, reviewed claim denials and corrected coding errors for resubmission
- Processed and submitted electronic and paper claims to insurance companies for reimbursement; sent appeals and reconsiderations using fax and online portals.
- Worked closely with the coding team on CPT code changes, DX code combinations, and appending accurate modifiers to get the claims paid. Maintained current working knowledge of CPT and ICD-10 coding, and CLIA certifications for lab services.
- Maintained accurate billing records by posting charges, payments, and adjustments based on claim requirements.
- Maintained detailed records of all billing activities, including denials, adjustments, and payments received, to track revenue and fix ongoing issues
- Audited accounts for missing information and documentation and worked closely with providers and clinics in creating standard processes, observing trends, and fixing errors.
- Developed strategies to enhance collections performance and minimize bad debt write-offs.
- Worked in multiple clinics and on different services, including urgent care, E/M services, physical therapy, and lab services giving me exposure to learn and work and collaborate with different departments creating me an opportunity to share best practices amongst departments increasing the quality of work.
SS2 Graduate student Assistant
University of North Texas
Denton, Texas
01.2023 - 05.2024
- Trained staff on checking eligibility, billing claims, medical records analysis for ICD 10 CM codes, Developed teaching resources and conducted training to ensure compliance with educational standards and maintain a secure educational environment.
- Managed student records, files, and confidential documents following University of North Texas procedures.
Process Trainer – Accounts Receivable
R1 RCM
Hyderabad, Telangana
02.2020 - 04.2022
- Trained new hires on medical terminology, ICD-10 coding standards, CPT codes, Diagnosis codes, claim authorizations, EMR updates, EOB review.
- Trained in electronic and paper billing methods, resolving clearinghouse rejections and accounts receivable (AR) denials.
- Demonstrated strong understanding of medical billing procedures and compliance, contributing to adherence to HIPAA standards.
- Monitored performance gaps and reinforced correct process steps.
- Updated SOPs and training guides for workflow changes.
- Coordinated with operations and quality teams on process and coding updates.
- Facilitated refresher training to support and enhance process quality and consistency.
- Developed and implemented training programs for new process employees.
- Analyzed existing processes and developed plans for improvement based on best practices.
Process Trainer
HINDUJA GLOBAL SOLUTIONS
Hyderabad, Telangana
10.2016 - 09.2019
- Trained new hires on DME accounts receivable, appeals, and rebilling processes to enhance their understanding and effectiveness.
- Developed training materials in line with HGS operational procedures to support consistent onboarding and knowledge transfer.
- Proven ability to drive revenue by effectively managing pre-authorization and retro-authorization denials. Skilled in negotiating with insurance providers and pursuing claim appeals to achieve optimal reimbursement.
- Managed lab services claims, addressed denials and rejections, and resolved correspondence issues to ensure timely claim processing.
Education
Master’s degree - health informatics
University of North Texas
Denton, TX05-2024
Skills
- SQL Python Tableau Microsoft Suite
- Communication skills Teamwork Problem-solving Adaptability Leadership Time management Creativity Critical thinking Absence Management Claims oversight Performance management Interpersonal skills
- ICD-10 coding
- CPT modifiers
- Claims adjudication
- Claims processing
LANGUAGE SKILLS
English, Hindi, Telugu
Accomplishments
- TTT Certified (Train the Trainer), Received the best trainer award in HGS and R1RCM.
Timeline
Medical Billing Specialist
Outsource Receivables.inc
08.2024 - Current
SS2 Graduate student Assistant
University of North Texas
01.2023 - 05.2024
Process Trainer – Accounts Receivable
R1 RCM
02.2020 - 04.2022
Process Trainer
HINDUJA GLOBAL SOLUTIONS
10.2016 - 09.2019
Master’s degree - health informatics
University of North Texas