Medical Billing Specialist | Claims Correction & Denial Mgmt

- Calendar & Email Management – Organizing schedules, prioritizing correspondence, and handling client communications. - Document & Records Management – Maintaining confidential files, legal documents, and client records with discretion. - CRM & Database Organization – Keeping client information up to date and well-structured. - Bookkeeping & Invoicing (QuickBooks) – Tracking expenses, processing payments, and ensuring accurate records. - Research & Report Preparation – Assisting with case preparation, legal research, and summarizing key documents. - General Administrative & Executive Support – Managing tasks to optimize efficiency and ensure smooth operations.

- Reviewed and corrected denied claim for plastic surgery services, ensuring proper use of CPT codes, modifiers, and supporting documentation. - Prepared and submitted a corrected claim with appropriate resubmission codes, addressing bundling denials and missing information. - Drafted comprehensive appeal letters to support claim reconsideration. - Coordinated directly with the provider to align clinical documentation with payer requirements. - Ensured all work adhered to HIPAA guidelines and payer-specific policies. - Demonstrated expertise in modifier selection (e.g., replacing Modifier 51 with Modifier 59) to show distinct procedures, improving the likelihood of approval.