Arun S.

Professional and Hospital Billing Expert In Software Testing Certified ISTQB , CSM Excellent experience in Medical Billing and coding, Application testing HL7, Telecom testing Medical Billing Applications knowledge: Intergy, Medical Manager, MDSynergy.com, Kareo, Advantax, Vericle,Medisoft, Officeally Clearinghouse Knowledge: ClaimRemdi, ViaTrack & Zirmed, Relay health using ACM tools Create the organization's dashboard by using excel with the help of various functions and coding(visual basic application). Having own freelance medical billing team. excellent experience in Healthcare industry (a good command on data entry in it from patient demography,eligibility & cash /Insurance payment posting/). Excellent knowledge how to increase the provider' revenue. While posting the payment,analysis it whether this is fewer payment or not. upload the era through clearinghouse and work on pending claims and check issued but not received ERA. Excellent analyzing over the payment and claims. work on rejected claims whether these are primary or secondary claims. download the eob from different site and approve them from provider and post them in the account. Excellent work on payment posting including URS payment (united resources system) and Patient services. Excellent command over rejections, claims, A/R as well. Handled Clearing House and its files i.e 835 which covers ERA and find out the missing ERAs which could not uploaded due to congestion. Software Documentation. Extensively work on bug resolving issues: like - batch history, out of batch payments issues, Reconciliation, Edit payment (missing of batch id and line items), Did end user testing on enhancement of ERA, CDF, Reason codes, Exception codes and A/R reports. Secondary claims were not getting generated after posting the partial payment, Cash patient where statement was not getting mailed to cash patients. Observed that Aetna claims should be send to payer as electronic not paper. Determined that EFTs are not getting downloaded from clearing house –claim remedi to ERA, secondary claim not getting generated after having 0.00 balances in primary. Raised these issues to engineering team and got succeed. Preparation of reports: worked on client’s Monthly Income Report, Services Level Agreement Report (SLA), Turn around time report (TAT Report), Quality report, Production report, Rejected claims report and various types of other reports. Suggested and extensively worked on various types of projects i.e. Credit Balance, CPTs which need to be written off, Cash patient. Work on denials and correspondence batches and made call to Insurances to get them resolved. Download the EOB from different types of websites and resolution the team member queries Raise fewer payment issues and tried to get them resolved asap.