Summary
Overview
Work History
Education
Skills
Accomplishments
Field Of Interest
Personal Information
Hobbies and Interests
Industrial Exposure
Projects
Training
Disclaimer
Timeline
BusinessAnalyst
Rushabh Shah

Rushabh Shah

Ahmedabad

Summary

Pursuing opportunities which will allow to grow professionally, which effectively versatile skill set to help promote institute mission and exceed team goals. Motivated medical billing and coding specialist with over 5 years of experience in health operations management, billing, and coding. Expertise in ICD-9 and ICD-10, CPT, and HCPCS coding. Highly skilled in analyzing and validating patient information, diagnoses, and billing data. Demonstrated leadership skills that enable the processing of high volumes of patient information to achieve revenue generation goals.

Overview

8
8
years of professional experience

Work History

Sr. RCM Specialist

RiverEdge Analytics Private Limited
Ahmedabad, GJ
06.2022 - Current
  • Oversee daily Billing Department functions, including medical coding, charge entry, claims, payment posting, and reimbursement management
  • Examine patients’ encounter forms to verify diagnosis codes and reconcile codes against services rendered
  • Accurately input procedure and diagnosis codes into billing software to generate invoices
  • Used electronic charge capture practices such as billing and account receivables (BAR) system and medical billing clearinghouse accounts to submit codes and invoices on time
  • Follow up on past due invoices and delinquent accounts to reduce number of unpaid and outstanding balances
  • Document patient data and medical records and perform routine medical record audits to comply with insurance company requirements
  • Uphold and reinforce compliance with hospital policies and federal regulations such as HIPAA
  • Resolved problems, improved operations and provided exceptional service
  • Projects - Physical Therapies, Acupuncture, Chiro, Psychology
  • Software - PrognoCis Team size – 05

Remote Medical Billing Specialist

Meditab Software Private Limited
Ahmedabad, GJ
09.2019 - 04.2022
  • Provided administrative support to physicians and interpreted medical reports and data to assign ICD-9 in and ICD-10 codes; entered diagnosis codes and patient information into billing software
  • Updated and managed diagnosis lists, coordinated routine documentation and coding audits, and executed qualitative analyses of discharged charges
  • Followed and maintained currency on coding, sequencing, and procedures’ best practices and updates
  • Reviewed and validated accuracy of charges, including dates of service, services provided, location, patient identification, and provider signature
  • Collected, posted, and managed patient account payments, and prepared and submitted claims forms to insurance companies and other third-party payers
  • Performed insurance verification, pre-certification, and pre-authorization
  • Entered procedure and diagnosis codes and requisite patient information into billing software to streamline invoicing and account management; added modifiers, verified diagnoses, and coded narrative diagnoses
  • Responded to staff and client inquiries regarding CPT and diagnosis codes
  • Project - Pain Management Software - Kareo, IMS Team size – 06

Assistant Store Manager

Neuation Technologies Private Limited
06.2016 - 02.2017

Responsible for inward and outward materials

  • Maintaining store (If materials are shorts against work order, then send purchase order request to Purchase Department
  • If materials are inward, then count it with workers and inward it in Bonrix software as per invoice with it's item code.) Assist all members of faculty planning for selection and acquisitions of store materials to support their activities
  • Equally effective working with independently and co-operative with user
  • Software - Bonrix Team size – 10

Education

Bachelor of Computer Applications -

H.N.G.U
Patan, GJ
06.2016

Skills

  • Creating different reports as per Client's requirements
  • Typing speed 55 wpm with 98% accuracy
  • Good verbal and written communication skills
  • Ability to deal with people diplomatically
  • Comprehensive problem-solving abilities
  • Efficient in working with Microsoft Office and Spreadsheets
  • Basic Knowledge of different operating systems and Billing software
  • Creating strong Appeal Contents based on Medical Record
  • Employer Billing and Calling
  • Patient Billing and Calling
  • Knowledge about PPO Contracts

Accomplishments

  • Awarded with Employee of the Month just in 3 months
  • Won 1st Prize of Best Dressed on Ethnic Day
  • Appreciated from clients

Field Of Interest

  • Software Installation and Repair
  • Medical Billing
  • Medical Coding

Personal Information

Date of Birth: 04/29/1994

Hobbies and Interests

  • Exploring new places and foods
  • Cricket and Movies

Industrial Exposure

Adani Port at Mundra, Kumarappa Handmade Paper Institute at Jaipur, Attended 15 days of training. The Institute has been working as a torchbearer for the handmade paper industry through its various activities, the most important among them is research and development activities being conducted in the Institute on the various aspects related to handmade paper sector, and for the betterment and upliftment of Indian handmade paper.

Projects

Online Food Ordering System, MySQL, ASP.Net 2010, Windows 7, 45 Days, 03, Representative

Training

  • Meditab Software Private Limited, 09/2019, 04/2022, Trained and mentored 6 new team members in medical billing procedures, software utilization, and best practices under my supervision. Provided guidance and support to juniors in understanding medical coding principles, insurance verification processes, and claims submission protocols. Allocated tasks and responsibilities, ensuring efficient workflow and adherence to quality standards.
  • RiverEdge Analytics Private Limited, 06/2022, present, Currently guiding a team of 5 members, imparting training on revenue cycle management (RCM) processes, including medical coding, charge entry, claims processing, and reimbursement management. Conducting regular coaching sessions to enhance team members' skills in accurately inputting procedure and diagnosis codes, complying with regulatory requirements, and effectively managing patient accounts. Facilitating the onboarding process for new employees, including orientation to company policies, software systems, and industry standards.

Disclaimer

Finally, I request to concerned authorities to provide me a chance, So I can prove the best myself and serve your esteemed organization which act of magnanimity. I shall be very grateful to you. I hereby declare that information given above is true the best of my knowledge. (Rushabh P. Shah)

Timeline

Sr. RCM Specialist

RiverEdge Analytics Private Limited
06.2022 - Current

Remote Medical Billing Specialist

Meditab Software Private Limited
09.2019 - 04.2022

Assistant Store Manager

Neuation Technologies Private Limited
06.2016 - 02.2017

Bachelor of Computer Applications -

H.N.G.U
Rushabh Shah