Khushboo Shamnani
Medical Biller
Vadodara
Summary
Certified Medical Billing Specialist with 1.5 years of experience in fast-paced, multiple-client medical billing company serving large private practice conglomerates and outpatient clinics. Researched denied claims and submitted appeals. Familiar with health billing and collections. Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors. Confident Medical Biller knowledgeable in data confidentiality and privacy practices when reviewing patient information.
Overview
1
1
year of professional experience
3
3
years of post-secondary education
1
1
Certification
Work History
Medical Billing Specialist
Medvantis Billing Solutions
Vadodara
01.2021 - 06.2022
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Reviewed patient records, identified medical codes and created invoices for billing purposes.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Prepared billing correspondence and maintained database to organize billing information.
- Responded to requests for information from various individuals by providing required documents.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Posted and adjusted payments from insurance companies.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Pre-certified medical and radiology procedures, Outpatient services.
- Referrals are taken for HMO plans for outpatient services like Chiropractic and Physical Therapy.
- Precisely evaluated and verified benefits and eligibility.
- Determined prior authorizations for medication and outpatient procedures.
- Maintained and updated collections tracking spreadsheet to help organize payment information.
- Located errors and promptly refiled rejected claims.
- Filed and updated patient information and medical records.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Posted payments and collections on regular basis.
- Delivered timely and accurate charge submissions.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Applied charges, updated patient records and done billing process by using Office Ally, ClinicDr, WebPT, Chart Talk EMR, EZClaims, Kareo and Charm Softwares.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Correctly coded and billed medical claims for various Outpatient facilities and Clinical Pathologies/Laboratories.
- Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Reviewed patient charts to better understand health histories, diagnoses and treatments.
Education
Bachelor of Commerce - Accounting And Business Management
Maharaja Sayajirao University
Vadodara, India 07.2018 - 06.2021
Skills
Accounts receivable management
Records Maintenance
Patient account analysis
Chiropractor and Physical Therapist billing knowledge
Medical claims submission
Certification
Medical Billing Certification
Timeline
Medical Billing Specialist
Medvantis Billing Solutions
01.2021 - 06.2022
Bachelor of Commerce - Accounting And Business Management
Maharaja Sayajirao University
07.2018 - 06.2021