Book Reading
Muntazir Mehdi
Credentialing & RCM SPECIALIST
Mishawaka
Summary
Personable and detail-focused professional with strong aptitude for managing complex processes and ensuring compliance. Familiar with healthcare regulations and capable of navigating credentialing procedures efficiently. Committed to enhancing operational efficiency and ensuring seamless provider onboarding. Experienced with credentialing healthcare providers and maintaining compliance across various regulatory standards. Utilizes data management and analytical skills to enhance credentialing accuracy and efficiency. Track record of building effective relationships with healthcare providers and team members.
Efficient Revenue Cycle Manager highly skilled in procedure optimization and revenue metrics analysis to increase financial performance. Aiming to utilize 10 years of account monitoring to drive profit and contribute immediate value.
Personable and analytical, bringing solid understanding of revenue cycle processes and financial management. Proficient in data analysis and process optimization, ensuring compliance with healthcare regulations and seamless revenue flow. Committed to driving efficiency and maximizing revenue through strategic planning and execution.
Overview
10
10
years of professional experience
3
3
Languages
Work History
Provider Credentialing Consultant
Self-employeed
03.2015 - Current
- Participated actively in the development and implementation of policies and procedures related to credentialing processes, ensuring alignment with industry best practices.
- Supported high-quality patient care by ensuring only qualified providers were admitted into networks.
- Assisted in resolving billing discrepancies by verifying provider information and updating necessary databases.
- Streamlined the credentialing process by implementing efficient tracking systems and documentation methods.
- Maintained confidentiality by adhering strictly to HIPAA guidelines during the handling of sensitive provider information.
- Achieved faster provider onboarding by collaborating with cross-functional teams to ensure timely completion of tasks.
- Reduced credentialing delays by proactively identifying potential issues and addressing them promptly.
- Conducted thorough audits of credential files to identify gaps or inconsistencies, leading to an overall increase in accuracy and reliability of provider data.
- Played an instrumental role in preparing organizations for accreditation surveys, ensuring that all credentialing requirements were met ahead of time.
- Enhanced compliance with industry standards through meticulous assessment of provider qualifications and credentials.
- Kept abreast of changes in regulations, policies, and best practices within the field, applying this knowledge strategically when reviewing applications from healthcare professionals.
- Collaborated with medical staff services to streamline communication and facilitate a smooth credentialing experience for providers.
- Managed multiple projects simultaneously, prioritizing tasks effectively to meet strict deadlines within a fast-paced environment.
- Provided excellent customer service to providers, addressing inquiries and concerns promptly while maintaining professionalism at all times.
- Enrolled providers and Medicaid, Medicare, and private insurance plans.
- Conducted primary source verifications such as background checks and board certifications.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
Revenue Cycle Specialist
Exponere Billing LLC
01.2021 - 01.2022
- Prepared detailed reports on billing activities and revenue outcomes, providing valuable insights for strategic decision-making.
- Trained new team members on revenue cycle best practices, contributing to a more knowledgeable workforce.
- Contacted responsible parties for past due debts.
- Enhanced revenue collection efficiency with robust follow-up procedures on delinquent accounts.
- Conducted detailed analyses of revenue cycle metrics, identifying trends and developing action plans to address areas of concern.
- Collaborated with cross-functional teams to improve overall financial performance of the organization.
- Collaborated with cross-functional teams to resolve billing issues, ensuring patient satisfaction and loyalty.
- Implemented comprehensive training program for new hires, focusing on nuances of healthcare billing and coding, which led to enhanced team productivity.
- Boosted financial performance, establishing strong relationships with insurance providers and negotiating favorable terms.
- Maintained clear documentation of all activities related to unpaid claims or denied services.
- Provided regular updates on billing status to upper management through detailed reports.
- Assisted patients in understanding complex billing statements, leading to increased trust between patients and healthcare providers.
- Balanced and reconciled accounts.
- Improved cash flow with diligent follow-up on pending claims and appeals processes.
- Enhanced transparency of financial policies to patients, reducing confusion and increasing upfront collections.
- Led initiatives to stay abreast of changes in healthcare regulations, minimizing compliance risks and avoiding potential penalties.
- Optimized revenue cycle, implementing effective strategies for claims management and reimbursement.
Team Lead
Physicians Revenue Group
01.2020 - 01.2021
- Completed financial reporting and analysis for billing revenue cycle.
- Monitored industry trends to anticipate changes that may impact the organization''s revenue cycle performance.
- Spearheaded integration of new electronic health records system, ensuring seamless data flow and improved billing accuracy.
- Provided staff training on revenue cycle management best practices, increasing productivity across the department.
- Monitored and guided revenue cycle operations.
- Implemented robust analytics platform for revenue cycle management, enabling data-driven decision-making and strategic planning.
- Improved patient satisfaction scores by simplifying billing process and enhancing transparency.
- Conducted detailed audits of billing and coding practices, identifying and rectifying compliance issues.
- Implemented process improvements, ensuring accurate charge capture and coding compliance.
- Reduced accounts receivable days outstanding, optimizing billing and collections efforts.
- Reduced denial rates through meticulous claims review and enhanced coding practices, ensuring maximum revenue capture.
- Conducted comprehensive risk assessments for revenue cycle processes, mitigating potential financial and compliance risks.
- Assessed current revenue cycle procedures and implemented improvements to foster efficiency.
- Developed and implemented training programs for new hires, leading to more competent and effective billing team.
- Championed system enhancements that improved automated billing functionality.
- Led cross-functional team to redesign patient intake process, resulting in improved data accuracy and smoother billing cycle.
- Reduced days in accounts receivable by implementing more efficient follow-up procedures with payers.
- Established continuous improvement culture within revenue cycle department, fostering innovation and efficiency.
Billing Analyst
Hardstone Enterprises
01.2018 - 01.2020
- Managed client relationships effectively, addressing concerns promptly and professionally to ensure continued business partnerships.
- Analyzed payment information and applied changes correct customer accounts.
- Verified daily coupon extraction process to enable correct execution of process.
- Maintained strict confidentiality with all personal data as per company guidelines.
- Implemented proper execution of monthly collection letters and escalation process.
- Coordinated with finance teams to develop annual budgets, incorporating historical data and projected growth rates for accurate forecasting purposes.
- Conducted monthly pre-billing review and data quality analysis to verify complete accuracy of invoices delivered to customers and providers.
- Updated pricing on orders in system to promote invoice accuracy for special items, agreements, substitutions and unauthorized deliveries.
- Functioned as key point of contact for billing data integrity matters for clients, vendors and various internal departments.
- Assisted clients and attorneys with requests for invoice copies, ledger details and explanation of accounts receivable amounts owed.
- Researched portals issues related to non-payment within e-billing vendor portals.
- Partnered with billing analyst department to investigate and remedy any gross margin trend issues.
- Designed and produced reports to highlight and explain collection issues and balances due, working with clients and attorneys simultaneously.
- Evaluated aging reports to identify members to be included in monthly outbound collection calls.
- Reviewed full history of past due accounts and contacted client or attorney regarding collection, implementation of payment plan or pursuit of legal remedies on unpaid accounts.
- Implemented process improvements that led to faster turnaround times for invoice approvals and payment processing.
Education
ACCA -
Skans School of Accountancy
04.2001 -
FSc Pre-Medical - undefined
BISE
Skills
Provider enrollment
Healthcare regulations
Audit preparation
Background checks
Credential verification
License monitoring
Insurance procedures
Data management
HIPAA compliance
Teamwork
Problem-solving
Time management
Complaint handling
Experience Summary
08+, 06+, 02
Interests
Badmintan
Photography
Timeline
Revenue Cycle Specialist
Exponere Billing LLC
01.2021 - 01.2022
Team Lead
Physicians Revenue Group
01.2020 - 01.2021
Billing Analyst
Hardstone Enterprises
01.2018 - 01.2020
Provider Credentialing Consultant
Self-employeed
03.2015 - Current
ACCA -
Skans School of Accountancy
04.2001 -
FSc Pre-Medical - undefined
BISE
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