Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

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

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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
Khushboo ShamnaniMedical Biller