Bijal Patel

Detail-oriented Medical Billing and Coding Professional with a proven track record of reducing claim denials and accelerating reimbursements. Expert in navigating major insurance portals including Availity Essential, Ability Inovalon, NGSConnex, and ePACES. Skilled in auditing documentation, correcting coding errors, and resolving complex outstanding claims to optimize department efficiency.

Senior Medical Billing and Claims Specialist - Assist Ambulance - 4420 Farragut Road

(2023-05)

• I processed complex medical claims using dedicated billing software to secure prompt, accurate payouts from commercial and government payers.
• I monitored claim adjudication across Availity Essentials, Inovalon, NGSConnex, ePACES, and insurance web portals to flag and appeal denials immediately.
• To drive down denial rates, I performed comprehensive upfront reviews of patient records to catch coding and billing discrepancies before submission.
• I utilized Accurint software to locate accurate demographic and insurance data, which significantly boosted successful skip-tracing and debt collection efforts.
• I spearheaded insurance collections by maintaining strict follow-up schedules with insurance providers regarding outstanding or aging accounts receivable.
• I submitted the timely filing appeals along with valid proof of timely submission.

Medical Billing Specialist - Columbia University Medical Center - New York, NY

(2018-06 - 2019-08)

• Knowledge of working with Epic, Idx, Crown and other insurance web sites.
• Responsibility for the proper and timely processing of multi-specialty claims and payments from state third party payers.
• Ability to navigate Medicare, Medicaid and third party website and applying all coding rules and use of CPT and ICD codes.
• Timely filling appeal process and follow up claims.

Medical Biller & Follow Up Representative - RTR Financial Services - Staten Island, NY

(2017-08 - 2018-03)

• Knowledge of working with EPIC system software, Crown, and other insurance web portals.
• Processing encounters and claims in the electronic medical record system.
• Identify and resolve insurance claims and client issues in a timely manner if necessary, submitting appeals in a timely manner.
• Meeting with partners regularly to discuss preparation and status of invoices.
• Performing transfers, write-offs, and adjustments.
• Working closely with partners and legal support staff to resolve and issue and ensure bills are accurate and complete.
• Drafting, finalizing, and posting invoices and maintaining billing files.

Medical Billing Supervisor - Jacob Nursing And Healthcare Agency - Brooklyn, NY

(2014-11 - 2017-07)

I managed full-cycle billing operations and consistently met or exceeded departmental reimbursement timelines.

• Processed and submitted medical claims using advanced billing software, ensuring compliance with regulations.
• I utilized an expansive suite of software platforms—including Epic, IDX, Epaces, Change Healthcare, Experience Health, Crown, and IGEA—to seamlessly manage medical billing workflows.
• I performed rigorous eligibility checks to accurately enter primary insurance and responsible-party details directly into patient charts, preventing downstream billing errors.
• I took full responsibility for the proper and timely processing of multi-specialty claims and payments from state third-party payers to ensure consistent cash flow.
• I drafted and submitted highly detailed medical appeals, paired with assertive, consistent follow-up to overturn wrongful insurance denials.
• I accurately applied payments, contractual adjustments, and approved write-offs to patient accounts as required by compliance guidelines.
• I posted Medicaid, managed care, and commercial check remittances while systematically correcting and resubmitting open or denied claims.
• I expertly navigated Medicare, Medicaid, and private payer websites to apply precise CPT and ICD coding rules for maximum reimbursement.
• I resolved complex customer and insurance inquiries via mail, email, fax, and phone in a highly professional and timely manner.

Accounting Manager - Axis Bank & Securities ltd - Anand, INDIA

(2010-04 - 2014-08)

• Responsible for maintaining petty cash records and updating of fixed asset register.
• Responsible for banking transaction like withdrawal of cash, submission of expense utilities bills to accounts department.
• Utilizes computer to prepare spreadsheets to analyze project data as per requirement.
• Managed vendor accounts, generating weekly on demand checks.
• Performed general office duties and administrative tasks.

Master of Science - Medical Billing - I board allied business school (2017-12)

MBA - Accounting And Finance - Madurai Kamraj University (2012-12)

Bachelor of Science - Accounting And Finance - Sardar Patel University (2011-03)