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Vipul
@vipulmaghudiya2
Medical Billing, Credentialing, Enrollment, AR, Clinic Setup
Indien
Hindi, Gujarati, Englisch
Über mich
I’m a CPCS & CPES Certified Provider Credentialing Specialist with 7+ years of experience in US healthcare credentialing and complete medical billing/RCM. Credentialing is my core expertise, including individual & group enrollment, Medicare, Medicaid, commercial payers, CAQH, PECOS, NPPES, PSV, payer contracting, re-credentialing, revalidation, EFT/ERA/EDI, and provider directory updates. I also handle the entire medical billing cycle, including eligibility, claims, AR, denials, payment posting, and follow-up. I focus on accuracy, timely follow-up, and getting providers enrolled and paid.
Kompetenzen
Vipul
offline •
Meine Dienstleistungen
Daten
I will be your expert medical biller and credentialing specialist
Web-Recherche
I will be your rcm or credentialing specialist
Portfolio
Arbeitserfahrung
Account Manager
Clinibooth Inc • Freiberufler
Jul 2024 - Present • 2 yrs 1 mo
Providing credentialing and RCM support for telehealth and outpatient clinics. • Managing provider enrollment, re-credentialing, and ERA/EFT setup with payers. • Handling Patient Scheduling • Handling eligibility verification, claims submission, AR follow-up, and denial management. • Supporting end-to-end RCM operations to improve collections and cash flow.
Sr. Credentialing Specialist
ACE Healthcare Solutions – Tampa, FL • Vollzeit
Oct 2022 - Aug 2024 • 1 yr 10 mos
Conducted eligibility and benefits verification using payer portals, TriZetto, and direct payer communication. • Submitted clean claims and managed full AR follow-up to reduce outstanding balances. • Posted insurance payments and reconciled accounts accurately. • Resolved billing discrepancies and payer denials through effective follow-up and appeals. • Served as subject matter expert for credentialing, AR, and billing workflows.
Sr. Medical Biller/ Credentialing Specialist
Axial Health Consultant Pvt Ltd (Salerno Medical Associates – NJ) • Vollzeit
Jul 2020 - Sep 2022 • 2 yrs 2 mos
Conducted eligibility and benefits verification using payer portals, TriZetto, and direct payer communication. • Submitted clean claims and managed full AR follow-up to reduce outstanding balances. • Posted insurance payments and reconciled accounts accurately. • Resolved billing discrepancies and payer denials through effective follow-up and appeals. • Served as subject matter expert for credentialing, AR, and billing workflows.
