As a Director of Billing for Pharmacogenetic (PGx) Testing Billing and Reimbursement, I lead the charge in ensuring the efficient and accurate management of billing processes for PGx testing services. I oversee claim submissions, reimbursement tracking, and payer communications, ensuring compliance with evolving regulations. My role involves streamlining workflows, resolving billing issues, managing denials and appeals, and maximizing revenue recovery. With over a decade of experience in medical billing and a strong focus on detail and problem-solving, I drive success through strategic insight, team collaboration, and a deep understanding of the complexities of PGx reimbursement.

DME Approval & Billing Process. ICD 10 and CPT coding. Initiate and obtain prior authorizations from insurance carriers. Posting insurance payments and entering charges. Chiropractic, Family Medicine, Pain Management billing experience ,Daily billing of insurance claims, follow up on unpaid claims, denial management and filing appeals when appropriate to obtain maximum reimbursement. Processing credentialing and re-credentialing Medicaid and Commercial applications of medical providers. Review provider enrollment packets for missing information and update; resolve information discrepancies. Performs a variety of administrative duties including, but not limited to: answering phones, faxing and filing. Perform Daily Financial Close and balance cash drawer at the end of each day. Appointment scheduling, as well as health insurance verification. Experience working with insurance companies and third party including Medicare, Medicaid and MCOs. A/R management and experienced in accounts receivables. Train employees, interview, and do background checks on employees. Handle all interactions with IT support.