Momin S

Medical Billing, Medical Biller, Credentialing and RCM consultant

Fiverr • Freelance

Jan 2019 - Present • 7 yrs 7 mos

I help healthcare providers, private practices, and medical groups improve cash flow by delivering accurate, efficient, and HIPAA-compliant medical billing services. With over 12 years of hands-on experience in US healthcare, I specialize in reducing claim denials, recovering aging AR and optimizing the entire revenue cycle. ✅ Revenue Cycle Management (RCM) Insurance Verification & Benefits (VOB) Prior Authorization Medical Billing & Coding Charge Entry & Clean Claim Submission Payment Posting (ERA/EOB) Denial Management & Appeals AR Follow-Up (30/60/90+ Days) Patient Billing & Support ✅ Credentialing & Provider Enrollment Medicare, Medicaid & Commercial Payer Enrollment CAQH Management & NPI Registration ERA, EFT & EDI Enrollment Provider Credentialing & Recredentialing Contracting & Practice Setup ✅ EHR & Billing Software Athenahealth • Kareo/Tebra • AdvancedMD • SimplePractice • TherapyNotes • eClinicalWorks • Office Ally • NextGen • Practice Fusion • WebPT • ICANotes • CareCloud ✅ Clearinghouses Availity • Waystar • Change Healthcare • Claim.MD • Optum • Navinet • PaySpan • Zelis ✅ Specialties Mental & Behavioral Health • Physical Therapy • Occupational Therapy • Speech Therapy • Chiropractic • Acupuncture • Home Health • DME • Sleep Medicine • NEMT • Laboratory • Primary Care ✅ Insurance Experience Medicare • Medicaid • TRICARE • UnitedHealthcare • Blue Cross Blue Shield • Aetna • Cigna • Humana • Anthem • Commercial Payers ✅ What I Deliver ✔️ High first-pass claim acceptance rates ✔️ Reduced denials and faster reimbursements ✔️ Recovery of outstanding Accounts Receivable ✔️ Accurate, HIPAA-compliant billing processes ✔️ Reliable communication and transparent reporting Let's Work Together I am committed to helping your practice increase collections, reduce administrative burdens, and strengthen your revenue cycle so you can focus on delivering exceptional patient care.

HIPAA certified Medical Biller | Medical Billing | RCM & Credentialing

Upwork • Freelance

Oct 2017 - Present • 8 yrs 10 mos

As a Freelance Medical Billing Manager on Upwork, I partnered with healthcare providers, medical billing companies, and healthcare startups across the United States to optimize their Revenue Cycle Management (RCM). I managed end-to-end billing operations, led remote billing teams, and implemented strategies to reduce denials, recover outstanding AR, and improve cash flow. My responsibilities included insurance verification (VOB), prior authorizations, charge entry, coding review (ICD-10, CPT & HCPCS), claim submission, payment posting (ERA/EOB), denial management, appeals, corrected claims, AR follow-up, patient billing, credentialing, provider enrollment, and revenue cycle reporting. I also trained billers, developed SOPs, monitored KPIs, performed quality audits, and worked directly with providers and practice managers to improve operational efficiency. I worked with leading EHRs and practice management systems, including Athenahealth, CareCloud (MTBC), Kareo/Tebra, AdvancedMD, eClinicalWorks, Office Ally, NextGen, Practice Fusion, TherapyNotes, SimplePractice, WebPT, ICANotes, and RXNT. I also utilized Availity, Waystar, Change Healthcare, Claim.MD, Optum, Navinet, Zelis, and PaySpan, along with Medicare, Medicaid, and commercial payer portals such as UnitedHealthcare, BCBS, Aetna, Cigna, Humana, Anthem, TRICARE, Molina, CareFirst, and WellCare. I supported clients across Mental Health, Primary Care, Physical Therapy, Occupational Therapy, Speech Therapy, Chiropractic, Home Health, Orthopedics, Cardiology, Pain Management, ABA Therapy, DME, Radiology, Sleep Medicine, Laboratory, and Urgent Care. Through my freelance consulting, I consistently helped clients improve clean claim rates, recover aging AR, reduce denials, streamline billing operations, and maximize reimbursements while maintaining HIPAA compliance and delivering exceptional client satisfaction. Profile Link: https://www.upwork.com/freelancers/mominshah4?mp_source=share

Medical Biller/CSE

CareCloud • Full-time

Sep 2014 - Sep 2017 • 3 yrs

As a Medical Biller at CareCloud (MTBC) I was responsible for managing the complete Revenue Cycle Management (RCM) process for a diverse portfolio of healthcare providers across the United States. My role involved ensuring accurate claim submission, timely reimbursements, and maintaining compliance with payer guidelines while working closely with providers, insurance companies, and practice staff. ✅Key Responsibilities Insurance eligibility and benefits verification (VOB) Prior authorization and referral management Charge entry and claim creation Medical coding review Electronic claim submission and rejection resolution Payment posting (ERA/EOB) and reconciliation Accounts Receivable (AR) follow-up for 30/60/90/120+ day aging Denial analysis, appeals, corrected claims, and reconsiderations Patient billing, refunds, and account resolution Credentialing support, ERA/EFT enrollment, and payer enrollment Identifying billing trends and recommending workflow improvements Maintaining HIPAA compliance and payer-specific billing standards ✅ EHR/Billing software I worked extensively with leading EHRs, including CareCloud, Athenahealth, Kareo/Tebra, AdvancedMD, eClinicalWorks, Office Ally, NextGen, Practice Fusion, TherapyNotes, SimplePractice, WebPT, ICANotes, and RXNT. ✅ I also utilized major clearinghouses and payer portals, including Availity, Waystar, Change Healthcare, Claim.MD, Optum, Navinet, Zelis, PaySpan, Medicare, Medicaid, Noridian, Palmetto GBA, Novitas, UHC Provider Portal, BCBS portals, Aetna, Cigna, Humana, TRICARE, Molina, WellCare, and Anthem for claim status, appeals, eligibility verification, and payment reconciliation. ✅ Throughout my career, I supported providers in a wide range of specialties, including Mental & Behavioral Health, Physical Therapy, Occupational Therapy, Speech Therapy, Chiropractic, Primary Care, Internal Medicine, Cardiology, Home Health, Orthopedics, Pain Management, ABA Therapy, Acupuncture, Laboratory etc