Medical Coding
CPT, ICD-10-CM, and HCPCS coding Compliance with payer and CMS guidelines Conducting coding audits to reduce denials and compliance risks
Professional Services
•Alexandria, VA
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Charge Entry
Accurate entry of charges from encounter forms or EHRs Validation of provider, patient, and payer data Timely posting to ensure faster claim submission
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Provider Credentialing
Initial provider enrollment with commercial payers and Medicare/Medicaid Re-credentialing and maintenance Tracking application status to prevent reimbursement delays
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Accounts Receivable (AR) Follow-Up
Proactive follow-up on unpaid and underpaid claims Communicating with payers and escalating issues as needed Regular reviews of AR aging
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Denial Management
Analysis of denial trends Timely appeals and submission of corrected claims Recommendations for process improvements to prevent recurring denials
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Claims Submission
Electronic claims submission to all major payers Claim scrubbing for accuracy and completeness Monitoring claim acceptance and rejections
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