Swaroop Karpe Email & Phone Number

Mumbai, Maharashtra, India

• Seeking an accomplished Medical Billing and Revenue Specialist with a strong track record in maximizing reimbursements and optimizing revenue using cutting-edge software solutions. • With 4+ years of experience as a Senior Account Receivable, I bring expertise in handling claims, resolving denials, Notes and driving financial success for healthcare organizations. My remote position perfectly aligns with my skills and experience. • My responsibilities are to efficiently manage… Show more • Seeking an accomplished Medical Billing and Revenue Specialist with a strong track record in maximizing reimbursements and optimizing revenue using cutting-edge software solutions. • With 4+ years of experience as a Senior Account Receivable, I bring expertise in handling claims, resolving denials, Notes and driving financial success for healthcare organizations. My remote position perfectly aligns with my skills and experience. • My responsibilities are to efficiently manage the end-to-end medical billing process for HCA scope (Form - CMS1500 & Higher Dollar Claims), leveraging advanced software solutions such as One Source (Eligibility & Benefits) , Onbase (EOB/ERA), Change Healthcare(Clearing House), AR Collaboration Tool (Credentials / NPI / Taxonomy) and Availity Portals (insurance websites and log in) to ensure accurate claim submissions and timely reimbursements. • Collaborate with insurance representatives and navigate payer websites to track claim status, address discrepancies, and expedite payment processing. Employ strategic appeal processes using software like E-Clinical (ECW 11) and Artiva software to overturn denials, minimize revenue loss, and optimize reimbursement rates. • Utilize expertise in medical coding guidelines and proficiency in various software systems to ensure compliance, enhance claim accuracy, and streamline workflows. • Analyze revenue cycle metrics using software-driven insights to identify process inefficiencies and implement targeted improvements, resulting in increased efficiency and financial performance. Show less

Navi Mumbai, Maharashtra, India

• Seeking a dynamic and results-oriented Medical Billing and Revenue Specialist with a strong background in maximizing reimbursements and optimizing revenue in the medical billing industry. With 3.5 years of experience as a Senior Account Receivable, • I possess a proven track record of successfully managing claims, resolving denials, Check on claim status and driving financial success for healthcare organizations. This remote position is ideal for my expertise as I currently reside in… Show more • Seeking a dynamic and results-oriented Medical Billing and Revenue Specialist with a strong background in maximizing reimbursements and optimizing revenue in the medical billing industry. With 3.5 years of experience as a Senior Account Receivable, • I possess a proven track record of successfully managing claims, resolving denials, Check on claim status and driving financial success for healthcare organizations. This remote position is ideal for my expertise as I currently reside in Maharashtra India, offering a unique perspective on the US medical billing landscape. • My responsibilities oversee end-to-end medical billing operations for Denial Mangement Scope, ensuring accurate claim submissions and timely reimbursement for US providers. Collaborate with insurance representatives to resolve claim status inquiries, address discrepancies, and expedite payment processing. • Develop strategic appeal processes as per process update tool / SOP to overturn denials, minimize revenue loss of provider, and maximize reimbursement rates and paid claims. Utilize extensive knowledge of medical coding guidelines to ensure compliance and optimize claim accuracy. For adding modifier/CPT/DX codes, tasking to Coding team & stay updated with evolving industry regulations, HIPAA compliance standards, and emerging trends to maintain a competitive edge. • Leverage advanced proficiency in medical billing software IDG Doc (Appeal Format/Forms), IDG Messenger (EOB retrieve/ Upload), Embillz (Posting Notes/ Adjustments/ Marker codes), ex. to drive operational efficiency and productivity.• Excellent communication and interpersonal skills for building relationships with Clients at all levels. Critical thinking and accuracy in prior analysis before taking any action and making calls. Show less

Maharashtra, India

• Handle a high volume of claims for US providers as well as for different facilities and hospitals/Billing Houses, ensuring accurate and timely submissions. • Communicate with insurance representatives to obtain claim status/Additional information/ and resolve any issues or discrepancies. Analyze Denials & Scenarios with DOS/Billed Amount/Current EOB/Denial reason/Resolutions/ Previous User notes EX. for developing effective strategies as per Client Operating Procedures (SOP) and Payer… Show more • Handle a high volume of claims for US providers as well as for different facilities and hospitals/Billing Houses, ensuring accurate and timely submissions. • Communicate with insurance representatives to obtain claim status/Additional information/ and resolve any issues or discrepancies. Analyze Denials & Scenarios with DOS/Billed Amount/Current EOB/Denial reason/Resolutions/ Previous User notes EX. for developing effective strategies as per Client Operating Procedures (SOP) and Payer Billing Guidelines to resolve denials and minimize revenue loss. • Prepare and submit appeals with supporting documentation to insurance companies mailing address/FAX number, if required. only after getting confirmation about Appeal Filling Limit, aiming to overturn denials and maximize reimbursements.• Collaborate with the billing team and coding team to identify trends, patterns, and areas for process improvement. Maintain a thorough understanding of medical coding and billing guidelines, ensuring compliance with HIPAA and PHI regulations. • Stay updated with industry changes and participate in training sessions to enhance knowledge and skills. Provide exceptional customer service to healthcare providers and Clients, addressing inquiries and concerns regarding billing and claim processes. Show less