Shah F.

Medical Billing and Revenue Cycle Management specialist with 7+ years of hands-on experience in athenahealth, Denial Management, and AR Recovery for US healthcare practices. I specialize in athenahealth and manage the full billing workflow from eligibility and benefits verification, claim submission, and payment posting to denial management, appeals, AR follow-up, credentialing, enrollment dashboard and all other configuration features. I have worked with practices in Primary Care, Cardiology, OB/GYN, Physical & Occupational Therapy, Pain Management, Urgent Care, and Mental Health, billing commercial insurance, Medicare, and Medicaid. Results I have delivered: 98%+ clean claim rate Recovered thousands in aged AR for each practice Max reduction in denials How I approach the revenue cycle I focus on preventing billing problems before they become accounts receivable. I verify eligibility and benefits, and I'm strong at reading through doctor's notes carefully to extract the correct billable diagnosis codes under Local Coverage Determination guidelines. I review documentation and billing details, scrub every claim for potential errors, and take preemptive action wherever possible so problems get caught before submission, not after a rejection or denial comes back. I would never treat denials as something to simply resubmit. I research the actual reason behind the denial whether it's eligibility, authorization, timely filing, coding, medical necessity, payer policy, or another issue then take the appropriate corrective action and handle the appeal or corrected claim when needed. I work aging AR systematically. I analyze aging reports, prioritize high-value and high-risk accounts, contact payers, research claim status and payment issues, and follow up consistently until the account is resolved. I handle payment posting accurately. I post insurance and patient payments, reconcile accounts, and make sure contractual adjustments and balances are recorded correctly. I also handle credentialing and payer enrollment. I support provider enrollment, payer applications, credentialing follow-up, and the administrative work required to keep providers participating with insurance networks. Systems & platforms I am highly experienced with athenahealth, Office Ally, AdvancedMD, eClinicalWorks (ECW), and Kareo/Tebra, along with payer portals and other healthcare billing platforms. I am comfortable stepping into an existing workflow, learning a practice's processes quickly, and working independently without constant supervision. I also have strong experience with IDR/NSA cases (Independent Dispute Resolution / No Surprises Act) and understand the billing-side requirements involved in out-of-network payment disputes. This includes reviewing claim and payment information, researching payer responses, organizing supporting documentation, and helping move cases through the appropriate dispute-resolution process. I also have training in HIPAA compliance and patient privacy, and I am comfortable communicating with patients about billing questions and balances in clear, professional language. Whether you need help with day-to-day Medical Billing, AR Recovery, Denial Management, Payment Posting, Claim Submission, Credentialing, or complete RCM, I bring both hands-on billing experience and a management perspective to the job. If your practice is dealing with growing AR, recurring denials, slow payer payments, or inconsistent billing processes, send me a message. I am happy to explain how I would approach your specific billing or AR problem using a de-identified example, so you can understand my process before deciding whether we're a good fit.