Sahari Dicritan

Sahari Dicritan Remote Medical and Dental Biller 0197 Barra Macabalan, Cagayan de Oro City, Misamis Oriental 9000, Philippines-whatsappp: - Experienced in both Medical Billing and Dental Billing with over 5 years of in-depth experience in the health care industry as an offsite Remote employee from the Philippines for several US practices. I am a High-level biller that is able to manage accounts and provide support to my clients. Promoted twice as a Lead Medical and Dental biller. I also have a background in Customer service and worked at the same time as a technical-support representative. Medical & Dental Billing Services: • Submitting Prior-Authorization/Pre-determination including the use of NEA FastAttach, Continuation of Care, creating narratives, and request for credentialing. • Check Eligibility and verification of patient’s health benefits from insurance carrier’s website or through phone call verification. • Patient scheduling • Full patient demographics and charge entry. Processing of Recurring payments for different mode of payments including credit cards and etc. • Insurance claims submission (primary, secondary or tertiary) • Payment Posting for EFT/ERA, cheque, or other forms of payment including Recoupment from insurance companies • Accounts receivable analysis with corrective and preventive actions and decision making for Collections • Strong claims follow up on denials from insurances like Workers Comp, Medicare, Medicaid, BCBS Semi Government, Managed care and Commercial Insurances (Aetna, BCBS, Cigna, UHC, Oxford etc...) • Patient billing inquiries as per received information from provider office • To check claim status from insurance, websites, auto response unit and via live calls. • To make on call appeals for reprocessing of incorrectly processed claims based on billing knowledge • ICD9, ICD10, CPT and HCPCS Coding and/or review • Daily, Monthly and annual AR Financial reports preparation • Creates custom reports if required • Patient billing as per instructions • Credentialing guidelines • Consulting/Training/Implementation of new billing procedures discovered • Super bill review • Creation of Paper Claim Appeals Medical & Dental Coding: • To identify and research the right DX and CPT code according to medical records and treatment selected by patients for dental billing. • Provide right DX pointers for the first time to avoid payment delays • Suggest appropriate modifier for maximizing the revenue Work Experience Dental Billing for Open Dental Altius Dental for Wallace Accounting & Advisory – Denton, TX August 2018 to August 2018 Assisted in cleaning up multiple dental offices that uses Open Dental. Work included cleaning up auto-adjustments made when there was a conversion made from EagleSoft as well as working accounts receivable using a Cloud based technology. Project length estimated to be 3 months but was able to finish it for 3 weeks only. Dental Billing & Financial Team Leader – Dolphin Mgt. Perfect Smile Braces - Bronx, NY April 2017 to June 2018 1. Provides support to front desk with all insurance related questions. 2. Handles MD, FIN, and FIN with Insurance patients. 3. Verify patient’s insurances and eligibility by following the insurance verification process. 4. Performs insurance audits 5. Timely submission of records, bonding and monthly/quarterly continuation form claims, retention claims and Predetermination approvals. 6. To run Accurate aging reports (claims and certifications) and clearing AR. 7. Denial management (appeals, recovery, further actions) 8. Revenue forecast 9. Conducts new hire trainings and new process trainings 10. Handling the Financial aspects of the company 11. Posting payments from insurance and from patient ledgers 12. Collections management for patient responsibility/patients with no insurance 13. Assisted Treatment coordinators when presenting financials 14. Processing recurring payments for credit card/debit card payments 15. Creating patient invoices and services rendered invoice 16. Handling unusual and complicated issues or queries Medical Biller Waiting Room Solutions - Internal Medicine and Otolaryngology/ENT - Florida June 2016 to August 2017 Responsible for collecting, posting and managing account payments. Responsible for submitting claims and following up with insurance companies. Essential Functions: 1. Prepares and submits clean claims to various insurance companies either electronically or by paper 2. Identifies and resolves patient billing complaints from patients, clerical staff and insurance companies 3. Prepares, reviews and sends patient statements 4. Evaluates patient’s financial status and establishes budget payment plans. Follows and reports status of delinquent accounts 5. Reviews accounts for possible assignment and makes recommendations to the Billing Supervisor, also prepares information for the collection agency 6. Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers 7. Processes payments from insurance companies and prepares a daily deposit 8. Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations Customer Service - Billing & Selling Specialist eBay Inc. - Cebu City February 2016 to April 2017 1. Address customers issue/s on billing, dial up connection details and information 2. Assist members on requests for closure of the account and help resolve other customer issues 3. Assist members in listing their items for auction, address any billing inquiries and help them in account reinstatement and cancellation 4. Support members in determining technical concerns and escalating issue if necessary. 5. Walk them through in navigating the site 6. Responsible for the monitoring customer transaction activities in an effort to detect fraud and prevent losses 7. Maintain the highest quality of customer service during calls, deal tactfully to resolve customer complaints, compliments and follow the appropriate company procedures 8. Up sell programs and services as required by the program Medical Billing Specialist for Pain Management Integrated Pain and Rehabilitation Center Solutions - Manhasset, New York November 2016 to March 2017 1. Create Arbitration Packages to be given to the Attorney 2. Ensures if appeals documents were done correctly 3. Payment Posting 4. Claims submission Provider Customer Support United Health Group global - Cebu September 2013 to February 2015 Provides Expertise on the ff.: 1. Interacts with customers to gather support data to ensure that invoices are accurate and works to resolve discrepancies. 2. Help to educate our customers on the processing of payments through online applications. 4. General claims support by reviewing, researching, investigating, and processing claims. 5. Authorize the appropriate payment and enter into our company databases. 6. Provides expertise and general claims support by reviewing, researching, investigating, and processing claims. Will authorize the appropriate payment and enter into our company databases. 7. Does research & review on processed claims for necessary adjustments or corrections. 8. Responsible for conducting research to identify errors in claims processing, and may work with other organizations to arrange for reimbursements. Education Bachelor of Science in Medical Technology Liceo de Cagayan University - Cagayan de Oro Skills Team Lead, Management, Medical Billing, Medical Records, Medical Coding, Medical Terminology, Training & Development, Communications, Financial Analysis, Financial Management, Financial Reporting, Medicaid, Medicare, PPO, Accounting, Accounts Receivable, Electronic Medical Records, Excel, Word, Customer Services, Lead Generation, Organizational Skills, PowerPoint, Data Analysis, Data Entry, Documentation, Medical Office Procedures Links  www.linkedin.com/in/saharidicritan  https://www.upwork.com/fl/saharidicritan