Vibha Bhand

RCM is the process of managing claims, payment and revenue generation. RCM encompasses everything from determining patient insurance eligibility and collecting co-pays to properly coding claims. The RCM process begins when a patient schedules an appointment, and it ends when the healthcare provider i.e. doctor has accepted all payments.

RCM Professional - Integrity Health care solution

(2024-04)

RCM is the process of managing claims, payment and revenue generation. RCM encompasses everything from determining patient insurance eligibility and collecting co-pays to properly coding claims. The RCM process begins when a patient schedules an appointment, and it ends when the healthcare provider i.e. doctor has accepted all payments.

• Created and submitted accurate claims (CMS-1500/UB-04) to insurance carriers
• Posted payments from ERAs/EOBs for insurance and patient accounts
• Applied adjustments and managed secondary billing when necessary
• Reconciled daily deposits and generated reports for AR tracking
• Reviewed, analyzed, and appealed denied or underpaid claims
• Resolved issues related to coding, eligibility, and modifier usage
• Monitored timely filing limits and documented all payer communications
• Addressed rejections from clearinghouses by correcting errors in demographics, insurance, CPT/ICD-10, and provider credentials
• Re-submitted corrected claims to ensure clean submissions
• Maintained consistent AR follow-up to reduce Days in AR and maximize collections
• Generated revenue and performance reports for management
• Worked cross-functionally with coding and front-desk teams to optimize work

Senior Process Associate - Wipfli India

(2019-01 - 2023-12)

Wipfli helps rural health providers, health systems, critical access hospitals, senior service providers and medical practices position themselves to remain solvent while seeking new avenues for growth. Wipfli have specialized team of healthcare professionals thoroughly understand the pressures placed on your leadership team and the challenges with increasing your market share through partner alignment, embracing new payment structures, and leveraging advancements in technology to gain insight into real time analytics.

• Keeps ledgers up to date on charges, collections, and balances
• Insurance and eligibility verification
• Responsible for maintaining resident trust accounts, petty cash and all other accounts
• Timely complete Medicare logs
• Maintain census and census mix data for MDS and CMI accuracy
• Working on LTC MCD/MGD care Room & board claim
• Submitted medicaid claim from state, Texas, MO, Michigan
• Review OCC/DX
• Entering ancillary charges for skill nursing facility

Senior Process Associate - Intergrity Medical Systems Inc

(2015-09 - 2018-10)

Integrity Medical Billing, Inc. helps assist chiropractors and physicians with their billing and practice management. They provide timely and accurate billing of all accounts via electronic and paper claim submission which is vital in terms of effective revenue cycle management. Integrity Medical Billing, Inc. manages all aspects of your billing cycle, ensuring quick and maximum reimbursements.

• Handling end to end RCM process
• Insurance and eligibility verification
• Maintaining the status report for client
• Demographic entry
• Giving training to new joining
• Monitoring team performance and productivity
• Verifying ICD and CPT as Per CMS guidelines
• Verification of patient's insurance eligibility
• Updating reports and tracking as per client requirement
• Assigning 100+ code in a day during medical billing process and created a claim to be paid by insurance carrier
• Ensure code are 100% accurate and sequenced correctly in accordance with government & insurance regulations
• Searched for information where the coding is complex and following up with the doctors in case insufficient information

Senior Executive - Accurate Billing Services

(2007-01 - 2010-08)

Accurate Billing Service, Inc., (ABS) is a medical billing/collection and consulting company that offers a wide range of services specifically tailored to the unique needs of each client. Established in 2007, ABS offers billing solutions to physicians, HME companies and other medical facilities that are dependent upon reimbursement from insurance carriers.

• Medical Documentation Procurement
• Monthly Patient Statements/Patient Telephone Calls
• Outcomes Reporting
• Amount receiver follow up
• MIS preparation

Masters - English - Mahila Mahavidyalay, Kanpur (2003-07 - 2005-04)

Bachelor - Arts - Mahila Mahavidyalay, Kanpur (2000-07 - 2003-04)