I have 2 years of experience in Healthcare Revenue Cycle Management. I am having exposure in Physician, Hospital and insurance company . I am proficient in denial management, Payment posting(Insurance and patient payments), Claims filing and insurance follow ups, Analyzing denied claims and fixing the denials.

Work as a key part of patient care, responsible for organizing and proper management of patient’s individual health needs in compliance with treatment plan cost, making sure that patient receives the most appropriate and most efficient treatment plan available at highest quality standards, considering cost effectiveness and insurance related measures. Responsibilities: manage patient’s health needs and insurance related issue including but not limited to:- Checking… Show more Work as a key part of patient care, responsible for organizing and proper management of patient’s individual health needs in compliance with treatment plan cost, making sure that patient receives the most appropriate and most efficient treatment plan available at highest quality standards, considering cost effectiveness and insurance related measures. Responsibilities: manage patient’s health needs and insurance related issue including but not limited to:- Checking patient’s eligibility for determined treatment plan.- Contact insurance company for pre-approval, Identify unusual denials and medical report requests and contact the Insurance Companies for clarification and resolution- Perform systematic approach in getting approval for insured patients and ensure proper compliance of health care professionals with treatment plan.- Facilitate transfer process to and from other health care facility. - Establish cost estimation for expected outcome in collaboration with health care team.- Evaluates care episodes for necessity, appropriateness, level of care and timeliness of admissions and discharges.- Review and distribute the pre-approvals to concerned departments in a timely manner- Analyze patient’s data and supplying payers with required medical report as per policy and maintaining ethics related to patient’s right of confedientlity. - Performs utilization management to promote effective utilization of healthcare resources to provide the highest quality of patient care in the most cost efficient setting.- Liaise with Finance Department to evaluate pricing and cost methodologies to ensure appropriate resource utilization and cost effective, optimum patient care during the development stages of any new medical or clinical service and expending of such services.- utilizes the coding programs and health information Systems in the interpretation of data and in the preparation of required reports and statistics Show less