Account Manager at Simi Tree Healthcare (2024-06 – Present)
Lead Account Manger at Care Cloud (2022-09 – 2024-06)
- Serving as the primary point of contact for key client account, building and maintaining strong relationships, and ensuring client satisfaction.
- Supervising and guiding a team of account managers or billing specialists, providing direction, support, and training as needed to ensure high-quality service delivery.
- Communicate with client and insurance's representative in USA (United States).
- Overseeing the end-to-end revenue cycle process, including claim submission, payment posting, denial management, and accounts receivable follow-up, to optimize revenue collection and minimize delays.
- Tracking and analyzing key performance metrics such as claim submission rates, denial rates, and collections to identify areas for improvement and implementing strategies to enhance efficiency and productivity.
- Ensuring that all billing activities comply with relevant healthcare regulations, such as HIPAA and Medicare guidelines, and staying up-to-date with changes in regulations to mitigate compliance risks.
- Addressing escalated issues or disputes from clients, payers, or internal stakeholders promptly and effectively to minimize disruptions to billing operations and maintain positive relationships.
- Checking/sending/replying SSC messages/Emails form providers' offices, NJ and other department.
- Conduct daily update meetings with the team to disseminate information regarding changes in rules and regulations across various insurance carriers.
- Identifying opportunities to streamline workflows, enhance billing processes, and implement best practices to improve overall performance and achieve organizational goals.
- Providing ongoing training and development opportunities for team members to enhance their skills and knowledge in medical billing practices, software systems, and industry regulations.
- Checking daily work (FTP/scanning/other received form the provider office.
- Overseeing and managing any additional tasks delegated by the supervisor.
- Generate monthly invoice for client in a timely and accurate manner.
- Prioritized and successfully resolved accounts receivable (AR) issues, focusing particularly on high-priority cases within the 60 - 120+ aging buckets.
Account Manager OPS at Care Cloud (2019-07 – 2022-09)
- Experience in preparing and submitting claims to insurance companies, including electronic and paper claim submissions.
- Understanding of various insurance plans, including Medicare, Medicaid, and private insurance, and familiarity with their billing requirements.
- Competence in managing accounts receivable, including following up on unpaid claims, identifying and resolving denials, and minimizing aging of outstanding balances.
- Skill in identifying and resolving billing discrepancies, claim rejections, and other issues efficiently to ensure timely reimbursement.
- Ability to review documentation and claims thoroughly to ensure accuracy and completeness, minimizing errors and rejections.
- Capacity to prioritize tasks, meet deadlines, and manage workload effectively in a fast-paced healthcare environment.
- Effective communication with patients, healthcare providers, and insurance companies to address billing inquiries, resolve disputes, and provide clarification on billing matters.
- Knowledge of healthcare regulations and compliance requirements, such as HIPAA, to ensure adherence to legal and ethical standards.
- Possess extensive experience and proficiency in accounts receivable (AR), billing, and payment posting.
