Medical VA

Managed communications with healthcare providers, addressing inquiries, complaints, and providing accurate information on policies, procedures, and services. Investigated and resolved claims, billing, and reimbursement issues while collaborating with internal teams to address complex provider concerns. Maintained detailed records, ensured compliance with CMS and HIPAA regulations, and accurately updated database information. Utilized software to manage provider data and generated reports on interactions, issue resolutions, and performance metrics.

Review accounts receivable reports to identify and address overdue payments. Initiate follow-ups via calls, emails, or correspondence to collect outstanding balances. Record, post, and accurately apply payments to appropriate accounts. Verify insurance details, submit claims, and follow up on unpaid or denied claims. Investigate claim denials, determine causes, and take corrective actions. Maintain organized records of payer interactions and payment activities. Stay updated on healthcare regulations, billing codes, and compliance requirements. Collaborate with billing and revenue cycle teams to address issues and streamline processes. Use healthcare information systems and billing software efficiently. Identify opportunities to improve processes and optimize systems for greater efficiency.

I have extensive experience ensuring HIPAA compliance across various healthcare-related projects. This includes managing and overseeing the implementation of privacy and security policies to protect patient health information (PHI). In my previous roles, I was responsible for: Risk Assessments: Conducting comprehensive risk assessments to identify and mitigate any potential vulnerabilities to PHI across systems and processes. Policy Development & Implementation: Developing, updating, and enforcing policies related to data protection, confidentiality, and breach reporting, in compliance with HIPAA regulations. Training & Education: Delivering ongoing HIPAA training programs to employees and stakeholders, ensuring they understand the importance of safeguarding PHI and adhere to established protocols.

I have extensive experience in medical billing, where I’ve been responsible for processing claims, ensuring accurate coding, and facilitating timely reimbursement for healthcare services. In my previous roles, my key responsibilities included: Claims Submission, Insurance Verification, Coding Accuracy, Denial and Rejection Management, Payment Posting and Reconciliation, Follow-up and Communication, Compliance and Regulations and Reporting and Documentation

I have extensive experience in the medical credentialing process, ensuring that healthcare providers meet all necessary qualifications and regulatory standards to deliver care. My responsibilities have included: Provider Verification, Accreditation Compliance, Credentialing Applications, Database Management, Collaboration with Insurance Companies and Payors, Ongoing Monitoring & Re-credentialing and Provider Support & Education

Dedicated and self-motivated professional with 8 years of experience managing US healthcare accounts, working with both provider and payer clients. Seeking a role where I can leverage my expertise in virtual assistance, strong communication skills, and comprehensive healthcare knowledge to enhance clinical operations' efficiency and deliver exceptional support to healthcare professionals and patients in a virtual environment.

I have comprehensive experience in healthcare denial management, focusing on the identification, analysis, and resolution of denied claims to ensure optimal reimbursement for healthcare services. In my previous roles, I have been responsible for Claim Review and Denial Analysis, Appeals Management, Collaboration with Providers and Payors, Utilizing Denial Management Software, Root Cause Analysis and Process Improvement and Compliance and Documentation