Medicare PCR, Intake, Auth, Scheduling, QA, & Billing Expert

Overview

Looking for full-time work (8 hours/day)

at $16.80/hour ($2,956.80/month)

Master's Degree

Last Active

May 4th, 2024 (yesterday)

Member Since

March 30th, 2018

Profile Description

• Organized admissions/intake coordinator with 10+ years of experience in the US Healthcare Industry from End to End of the Revenue Cycle Management (Referal Coordination, Admissions/Intake, Scheduling, Welcome Call/Patient Outreach, Authorization/Precert/RCD, Quality Assurance, Medical Billing, Denial Management, Payment Posting, Appeals).
• Experience with home health, physical therapy, mental health and substance abuse, orthopedic, ambulance services, and autism services provider specialties.
• Excellent English Written and Communication Skills.
• Knowledge and expertise of the entire Revenue Cycle Management from end to end (Admissions/Intake, Scheduling, Authorization/Precert/RCD, Medical Billing, Denial Management, Payment Posting, Appeals).
• Successfully passed Medicare PCR (pre-claim review) and ADR (additional documentation request) for five different home health agencies with 100%, 98%, 96%, 95%, and 94?firmation rates during different RCD Cycles in Texas.
• Knowledge of HMOs, Medicare, Medicaid, Medicare Advantage, and Commercial Plans
• Versatility in Utilizing Insurance Portals like Availity, Optum, UMR, CareCentrix, Cigna, Value Options, My Ability, Navinet, DOL, eServices, My CGS, NGS, NH Healthy Families, WellSense, eVicore among others. 
• Expertise in Medicare RCD/PCR and Precertification Processes and Requirements.
• Familiarity of ICD-10 Coding, Outcome and Assessment of OASIS, 485, and other notes.
• HIPAA Compliance.
• Office Support and Management (familiarity with filing, phone, faxing applications such as Ring Central, 3CX, Fax.Plus, and Nextiva).
• Knowledge of RCM Platforms like Trizetto, Waystar/Zirmed, Office Ally.
• Knowledge of CRM and ERM Software like Salesforce, Prosperworks, Rethink, Opus, ClinicSource, Axxess, Wellsky/Kinnser, Kareo, Alora Plus, Practice Fusion, Salesforce, Carelon, Home Health Notify, Aidyn among others.
• Experienced on reviewing patient charts, documentation, medical notes.
• Experienced on patient coordination/medical care coordination.
• Team Player with Positive Attitude and Strong Work Ethic.