Vanitha Shree
Bangalore
Summary
Organized Medical Biller thoroughly versed in medical coding and HIPAA requirements. Personable professional with several years of hands-on experience claiming refunds, reviewing claims, and maintaining billing reports. Accommodating and helpful team player proficient in job-related billing software. Quality-focused Medical Biller offers strong track record over many years in settling and resolving complex patient billing accounts. Thoroughly experienced in handling medical charges and invoicing. Tech-savvy approach to understanding and resolving difficult areas of dispute.
Overview
9
9
years of professional experience
Work History
RCM Medical Billing Specialist
InfimedSolutions
Gujarat
03.2023 - 08.2024
- Resolved discrepancies between insurance companies and patients regarding payment of bills.
- Prepared daily reports summarizing payments received from insurers or other sources.
- Assisted with the reconciliation of accounts receivable ledgers at month-end close process.
- Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
- Created and processed claims to third-party payers using specific coding guidelines.
- Adhered to HIPAA regulations when handling confidential patient information.
- Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
- Performed quality assurance audits on submitted claims ensuring that they met industry standards.
- Initiated collection efforts on unpaid accounts by contacting insurance companies or patients directly via phone or mail.
- Conducted research on insurance policies, procedures, and regulations to ensure compliance with all applicable laws.
- Maintained detailed records of all billing activities including denials, adjustments, and payments received.
- Developed strategies for improving collections performance while reducing bad debt write-offs.
- Generated monthly invoices for patients based on services provided according to established fee schedules.
- Monitored aging accounts receivable balances ensuring timely resolution of outstanding balances.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Determined prior authorizations for medication and outpatient procedures.
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Submitted refund requests for claims paid in error.
- Reviewed engine assigned codes and modifiers to update and verify accuracy.
- Executed account updates and noted account information in company data systems.
- Submitted claims to insurance companies.
- Performed accurate and fully compliant monthly closing processes, accruals and journal entries.
- Expedited payments by verifying accuracy and currency of vendor information.
- Collected, posted and managed patient account payments.
- Assessed billing statements for correct diagnostic codes and identified problems with coding.
Executive Quality and Trainer RCM
GetixHealth India PVT LTD
Bangalore
10.2021 - 03.2023
- Conducted onboarding sessions to orientate new staff members about company policies and procedures.
- Recommended changes or improvements in existing training processes as needed.
- Designed and developed training materials for new employees in the organization.
- Documented all training activities including attendance records, feedback forms, surveys.
- Maintained up-to-date knowledge of industry trends and best practices.
- Provided feedback on employee performance based on observed results during training sessions.
- Resolved any issues raised by participants during the training session in a timely manner.
- Created multimedia presentations with PowerPoint and video conferencing tools.
- Managed multiple projects simultaneously while adhering to tight deadlines.
- Maintained up-to-date records of trainee progress and provided regular updates to management team.
- Assisted with developing online learning modules for remote learners.
- Adapted teaching methods according to the needs of individual learners or groups.
- Trained newly hired top talent to fill key positions and maximize productivity.
- Explained goals and expectations required of trainees.
- Created and offered additional materials to enhance training.
- Devised programs to develop executive potential among employees in lower-level positions.
- Monitored training costs and prepared budget reports to justify expenditures.
- Selected and assigned instructors to conduct training.
- Suggested and offered specific training programs to help workers maintain or improve job skills.
- Evaluated modes of training delivery to optimize training effectiveness, training costs or environmental impacts.
- Assessed training needs through surveys, interviews with employees or focus groups.
- Participated in and attended meetings or seminars to obtain information for use in training programs.
Senior AR Caller - Medical Billing
Guide House India PVT LTD
Bangalore
07.2019 - 07.2021
- Analyzed data collected during call attempts and identified areas where processes can be improved.
- Prepared detailed reports of customer account information for management review.
- Collaborated with other departments when necessary to resolve issues related to delinquent accounts.
- Identified opportunities to increase collections efficiency and accuracy through process improvements.
- Assisted other AR Callers with inquiries or requests related to their assigned accounts.
- Investigated discrepancies between customer accounts and internal records.
- Conducted follow-up calls to insurers to ensure prompt payment of claims submitted by physicians and providers.
- Verified insurance coverage eligibility with insurance companies.
- Monitored aging reports to identify unpaid or overdue accounts receivable balances.
- Reviewed patient accounts for accuracy and completeness of insurance information.
- Maintained up-to-date knowledge of coding systems such as ICD 10 and CPT codes used in medical billing processes.
- Worked closely with other departments such as accounting and customer service to ensure accurate processing of claims and payments.
- Resolved complex billing issues in a timely manner.
- Generated patient statements for unpaid balances due after insurance payments were applied.
- Documented all communications with insurers, both verbal and written.
- Maintained an organized filing system for all documents related to medical billings and collections.
Medical Billing Associate
Decipher Health Record
Mysore
06.2017 - 06.2020
- Processed medical claims using appropriate codes to ensure accurate reimbursement.
- Generated reports to track payments received from insurance companies and other entities.
- Provided training to new employees on proper procedures related to medical billing processes.
- Resolved coding errors by working directly with providers and staff members.
- Analyzed account histories for payment patterns or irregularities that require further investigation.
- Maintained patient records, verifying accuracy and completeness of data entered into the system.
- Identified incorrect coding issues that may result in underpayments or denials of claims.
- Entered charges for services rendered into the computerized billing system.
- Ensured all documentation is properly completed prior to submitting claims electronically or manually.
- Identified areas where process improvements could be made within the department.
- Assisted in resolving discrepancies between bills and insurance companies.
- Developed strategies to improve collection efforts of outstanding balances due from payers.
- Provided customer service support to patients regarding their billing inquiries.
- Corresponded with insurance companies via phone, email, or fax regarding claim status updates or denials.
- Reviewed Explanation of Benefits statements from insurance carriers for accuracy.
- Reviewed patient accounts for accuracy and compliance with federal regulations.
- Processed payments from customers in a timely manner according to established procedures.
- Followed all federal, state, and local laws related to collections practices.
- Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future problems.
- Worked closely with delinquent account holders to collect and reconcile accounts through approved channels.
- Accepted and processed customer payments and applied toward account balances.
- Answered customer questions regarding account discrepancies or problems.
Executive AR Caller
Sys Information
Mysore
01.2016 - 03.2017
- Analyzed accounts receivable data to ensure accuracy of patient records.
- Corresponded with customers via email or phone regarding billing inquiries or disputes.
- Provided customer service to patients regarding medical bills, insurance claims and payment plans.
- Performed monthly reviews of aging reports for assigned accounts.
- Entered customer information into the system accurately and completely.
- Followed all federal, state, and local laws related to collections practices.
- Processed payments from customers in a timely manner according to established procedures.
- Worked closely with other departments to resolve account issues quickly and efficiently.
- Wrote appeal letters to insurance companies for denial of claims.
- Used excellent verbal skills to engage customers in conversation and effectively determine needs and requirements.
- Spoke with customers to learn reasons for overdue payments and to review terms of credit contract.
Education
Bachelor of Engineering - Computer Science And Programming
GSSSIETW
Mysore06-2015
Skills
- Quality-oriented team player
- Medical Billing software applications proficiency
- Files and records management
- Generally Accepted Accounting Principles
- Denial Management
- Billing Guidelines
- HIPAA Compliance
- Claims review
- Payment posting
- Insurance Verification
- Billing and Collection Procedures
Timeline
RCM Medical Billing Specialist
InfimedSolutions
03.2023 - 08.2024
Executive Quality and Trainer RCM
GetixHealth India PVT LTD
10.2021 - 03.2023
Senior AR Caller - Medical Billing
Guide House India PVT LTD
07.2019 - 07.2021
Medical Billing Associate
Decipher Health Record
06.2017 - 06.2020
Executive AR Caller
Sys Information
01.2016 - 03.2017
Bachelor of Engineering - Computer Science And Programming
GSSSIETW
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