Jaswinder S.

DME Billing & Coding Specialist | Medical Billing & Coding Specialist | Expert in Medicare and Commercial Payer’s Claim Submission, A/R, and Denial Management I am a dedicated and results-driven professional with over 8 years of experience in Durable Medical Equipment (DME) Billing, Physician Billing, and Medical Billing & Coding. I specialize in delivering comprehensive Revenue Cycle Management (RCM) solutions, including DME intake, eligibility verification, claim submission, rejection & denial management, and A/R follow-up. My commitment is to provide precise, efficient services that optimize your revenue stream and reduce claim rejections. As a former team lead and RCM Manager, I have led successful billing teams, enhanced RCM processes, and collaborated with developers to optimize billing software solutions. I focus on ensuring compliance with Medicare guidelines, HIPAA regulations, and payer-specific requirements for Medicare, Medicaid, and commercial insurance providers. My experience spans working with some of the largest DME suppliers in Florida, California, and New York, using industry-leading platforms such as BFLOW, Brightree, TriZetto, DME Hub, Integra, Que Portal, and Athenahealth for seamless claim management. Core Specialties: • DME Intake & Billing • Medical Billing & Coding (ICD-10, CPT, HCPCS) • Medicare Guidelines & Compliance • Eligibility Verification & Claims Submission • Denial Management & Rejection Resolution • Accounts Receivable (A/R) Management • Team Leadership & Process Improvement Medical Billing Services Overview: I offer full-service Medical Billing solutions at competitive rates, including soft collections. My services include: • Eligibility Verification: Verify patients' insurance benefits via portals and phone calls. • Appointment Scheduling: Schedule appointments during patient calls. • Charge Entry & Claims Submission: Enter full patient demographics, submit claims for primary, secondary, and tertiary payers. • A/R Analysis & Collections: Analyze A/R data, take corrective actions, and develop strategies for collections. • Denial Management: Proactively follow up on denials from Workers Comp, Medicare, Medicaid, and private insurers (BCBS, Aetna, Cigna, UHC). • Claims Follow-Up: Check claim statuses via websites, live calls, and automated systems. • On-Call Appeals: Submit on-call appeals for reprocessing incorrectly adjudicated claims. • ICD-10, CPT, HCPCS Coding: Utilize Encoder Pro Expert to ensure precise coding and claim accuracy. • Financial Reporting: Prepare comprehensive A/R reports—daily, monthly, and annually—and offer custom reports as needed. • Credentialing Services: Provide credentialing support and consulting for provider compliance with payer requirements. Medical Coding Services: • Accurate Coding: Research and assign correct ICD-10, CPT, and HCPCS codes based on medical records. • Modifier Application: Apply correct modifiers to maximize reimbursement. • Coding Audits & Compliance: Ensure compliance with payer guidelines to avoid coding errors and denials. Specialties: I have hands-on experience across a wide range of medical specialties, including Anesthesiology, Cardiology, Chiropractic, Dermatology, Emergency Medicine, Family Practice, Internal Medicine, Orthopedics, Pediatrics, Radiology, and many more. In addition, I lead a small, experienced team of medical billing and coding experts ready to handle projects of any size, from smaller assignments to large-scale billing operations. We prioritize timeliness, accuracy, and client satisfaction. To ensure we're the right fit for your project, we offer a trial period of 2 to 7 days before you commit to larger engagements. Why Choose Us? • Proven track record of success with major DME suppliers. • Extensive expertise in navigating Medicare guidelines, CPT, ICD-10, HCPCS, and payer-specific requirements. • Competitively priced services tailored to meet your needs. • Dedicated support for handling claims, denial resolution, and collections. Technical Skills: • Billing Software: BFLOW, Brightree, DMEhub, Athenahealth • Claims Management Platforms: TriZetto Enrolment Portal, Que Portal • Medical Coding: ICD-10, CPT, HCPCS • Payer Portals: Medicare, Medicaid, Commercial Insurance Payers • Other Portals: Availity, Integra Que portal and payer portals • Reporting & Analytics Tools: MS Office, CRM reports • DME Guidelines: Complete knowledge of Medicare guidelines and DME products. We are confident in exceeding your expectations and delivering unmatched value in the industry. Let's collaborate to streamline your billing processes and optimize your revenue!