Mohib

Manager Operation

Fiverr • Freiberufler

May 2018 - Present • 8 yrs 2 mos

Manage end-to-end Revenue Cycle Management (RCM) for multiple healthcare providers. Oversee insurance verification, eligibility, and benefits verification. Submit and monitor electronic and paper claims to commercial insurance companies, Medicare, and Medicaid. Investigate and resolve claim denials and rejections by communicating with insurance representatives through payer portals, phone calls, and live chat. Perform Accounts Receivable (A/R) follow-up to ensure timely reimbursement. Process payment posting, adjustments, refunds, and reconciliation of insurance and patient payments. Review medical documentation, CPT, ICD-10, and HCPCS codes to ensure billing accuracy and compliance. Work with behavioral health providers on claim submission, payment reconciliation, and revenue optimization. Utilize billing software including eClinicalWorks (eCW), Kareo, CareCloud, Medifusion, EZClaim, and eThomas. Coordinate with internal teams to improve billing workflows, reduce claim denials, and maximize collections. Maintain HIPAA compliance while handling protected health information (PHI). Train and support team members on billing procedures and payer guidelines