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
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