Ibrar Q.

RCM and Medical Biller | Credentialing Specialist

I have experience of 6-year in Medical Billing. I have been exposed to most of the areas in Patient and Insurance Billing such as: 1. Patient account management which includes patient registration and appointment scheduling. 2. Verification of patient eligibility and benefits and identification of correct payers. 3. Claims Creation from EMR or Superbill 4. Resolving Clearinghouse rejections and some EDI errors 5. Verification of Provider Contract Info [contract, network participation, contract fee schedule] with payers/insurances to assure that providers are being paid correctly 6. Payment Posting from insurances and patient and dealing with Zero-Paid EOB's 7. Setting up ERA and assisting in provider's EFT setup 8. AR follow up which includes insurance phone calls 9. Resolving claim issues and denials 10. Registration of provider tools such as Availity, Navinet, UHC-Link, Optum, etc. Aside from professional billing, I was also able to handle a practice that does Facility Billing [uses UB-04 form]. I possess exceptional knowledge in anatomy and physiology, pharmacology, and CPT and diagnosis coding. Apart from medical claims, I also have experience in submission of EAP and Worker's Comp Claims. I am proud to say that the sites/practices I have worked with had zero to minimal instances of denials that can no longer be reversed. Part of my experience is being a Team Lead/Assistant Billing Manager for 1 year overseeing 22 practices in different states in USA. For this reason, I am adept in dealing with wide array of commercial insurances, state Medicaid’s, different contractors of Medicare’s, and Medicare Supplemental Insurances. As an RCM Team Lead, I created practices' RCM reports and present these to providers/clients in a monthly basis to resolve issues that hinders increased revenue. Other responsibilities that I handled are training new hires, answering and resolving escalations, and coaching each team members on how to resolve issues and increase their productivity. I have been known with great quality of work. Once I start working in a site, I really try to research the codes and way of billing and learn the needs of my practice to be able to contribute more fully. One of my commendable skill is to help the site troubleshoot medical codes used in their practice and billing issues. In this way, I could help the site to increase their revenue and avoid unnecessary rejections or denials. In addition to these. I've been known not just by my managers but also my work mates and team mates as someone who is always available to share my knowledge and experience in resolving an issue and who is always ready to assist. One of my great attribute is being trustworthy. I always make sure that if I don't have enough work load in my sites, I always inform my Billing Managers so they can add me more tasks that need to be attended to. This is also my way to show that I really value my job and the experiences I can gain when faced with different tasks or issues. Before I ventured in medical billing and coding career, I was working in the field of online English teaching. I am fluent in English and can work well with other people. My online navigation career has been enhanced when I started to work as a part-time essay editor for a year and as an office-based full time online English teacher for almost 2 years. I am always driven in doing my task or job very well. When I was working as an online English teacher, my company let me focus in teaching Business English course which is the highest and most difficult course our company is providing at those times. One advantage I have gained in teaching this course is that it has let me tweak my knowledge with creating email and business letters and email etiquette. Aside from being familiar with MS Office tool and other use of applications and software, I can also type at least 40 words per minute with 98% accuracy. I have very good analytical and designing skills and can find ways to solve work-related problems even with minimal supervision. I have strong commitment to excellence and is looking for a new facet in medical billing career and online English teacher career that would provide further growth and development. Hire me and I will give you quality results!