Kalpana Surani

Self-motivated and enthusiastic competent working professional who enjoys the challenges of tasks completed efficiently. As a highly skilled and detail-oriented Medical billing, AR Follow-up & Denials Management expert, I have over 2.5+ years of experience in US Healthcare Industry. I have a strong understanding of Billing systems, insurance policies, and billing processes, and I am proficient in using a variety of medical billing software. My goal is to help healthcare providers improve their billing and revenue cycle management, while also ensuring compliance with industry standards.

Medical Billing Services:

• To check Eligibility and verification of patient’s health benefits from insurance carrier’s website and through Phone.

• Full patient demographics and charge entry

• Insurance claims submission (primary, secondary or tertiary)

AR Follow up & Denials Management:

• Accounts receivable analysis with corrective and preventive actions and decision making for Collections

• Strong claims follow up on denials from insurances like Workers Comp, Medicare, Medicaid, BCBS Semi Government, Managed care and Commercial Insurances (Aetna, BCBS, Cigna, UHC, Oxford etc...)

• Patient billing inquiries as per received information from provider office

• To check claim status from insurance, websites, IVR and via live calls.

• To make on call appeals for reprocessing of incorrectly processed claims based on billing knowledge

• ICD9, CPT and HCPCS Coding and/or review,

• Daily, Monthly and annual AR Financial reports preparation

• Custom reports wherever required

• Patient billing as per instructions

• Credentialing guidelines

• Consulting/Training

• Super bill review

• Appeals

• Opening negotiations and getting claims processed at higher rates.

Skills:

• Medical billing

• Insurance claims processing

• Revenue cycle management

• Electronic health records (EHR e.g., ChiroTouch, Practice Fusion, PrognoCIS, Apex, AdvancedMD, etc.)

• Medical billing software (e.g. AdvancedMD, ECW, AthenaHealth, Kareo)

• HIPAA compliance

• Customer service

Experience:

• Successfully processed over 10,000 insurance claims for a large medical practice, resulting in more than 20% increase in revenue

• Trained and supervised a team of more than 20 medical billing specialists & AR Follow up executives

• Assisted with audits and audits to ensure compliance with HIPAA regulations

I am dedicated to provide excellent service and ensuring the financial success of healthcare providers. Please don't hesitate to contact me to discuss how I can help your practice or organization for getting your claims processed at a higher rate.