Shagufta S.

Medical Billing & Revenue Cycle Management Consultant ________________________________________ Professional Summary Dedicated and experienced Certified Professional Biller (CPB) 3 years in the medical billing and revenue cycle management (RCM) industry. Proven expertise in managing large teams and streamlining billing operations for various healthcare providers. Adept at handling insurance claims, payment posting, and denial resolution, ensuring optimal reimbursement for medical practices. Committed to delivering high-quality service, improving workflows, and reducing claim denials. ________________________________________ Key Skills & Expertise • Medical Billing & RCM: Insurance eligibility verification, claim submission, payment posting, A/R follow-up, denial resolution, and appeals. • Workflow Optimization: Identifying inefficiencies, drafting new workflows, and improving revenue cycle processes. • Insurance Provider Expertise: Extensive experience with Medicare, Medicaid, UHC, Cigna, BCBS, AARP, Tufts, and more. • EHR & EMR Proficiency: • Medisoft • CareCloud • Advanced MD. • Office Ally. • Drchrono • Collaborate MD. • ECW (E-clinical Works). • Kareo (Tebra) • Emdeon EHR/EMR system • EPM (Electronic Practice Management). •Crystal PM •Jane • Technical Skills: Microsoft Office 365, Smartsheet, Google Suites, OneDrive. ________________________________________ Healthcare Specialties Managed • General Practitioner & Family Medicine • Mental & Behavioral Health, Psychiatry • Podiatry, Chiropractic, ENT & Audiology • Dermatology, Substance Abuse Facilities • PIP No-Fault & Workers’ Compensation ________________________________________ Professional Experience Medical Billing Specialist [AMBC-Advance Medical Billing Company] • I have used my skills as a billing specialists, ensuring efficiency and accuracy in medical billing processes. • Managed full-cycle medical billing operations, including insurance claim submissions, payment posting, and A/R follow-up. • Successfully resolved claim denials and implemented strategies to reduce recurring issues. • Developed and optimized workflows to enhance revenue cycle processes for multiple healthcare specialties. • Maintained compliance with industry regulations and insurance policies to ensure accurate billing practices. VA and Medical Billing Specialist [Nobility Medical Billing Services.] • Performed my duties as VA, Patient benefits verification and getting Pre-authorization on daily basis. • Processed insurance claims for various specialties, including mental health, family medicine, dermatology, and chiropractic. • Conducted eligibility verifications and ensured timely claim submissions for maximum reimbursement. • Collaborated with insurance companies to resolve denied or underpaid claims. • Trained new employees on billing procedures and best practices. Let’s connect and explore how I can assist you.