Hamza Hasan

Responsibility Collection Specialist: 1: Support revenue cycle operations for a large, multi-state practice with 200+ providers and multiple facility types, including outpatient, inpatient, rehabilitation, emergency care, and incentive-based outpatient services. 2: Assist the credentialing team by verifying provider network status with payers, ensuring accurate plan participation and avoiding out-of-network billing issues. 3: Manage high-volume claim submissions (500+ daily), while proactively identifying and resolving rejections and denials to ensure first-pass claim acceptance. 4: Review diagnosis (ICD) and procedure (CPT/HCPCS) codes, along with modifiers, to identify errors before claim submission—ensuring coding compliance and reducing repeat denials. 5: Resubmitted corrected claims as needed and tracked their status to ensure proper reimbursement and minimal delays. 6: Collaborate with billing teams to implement corrective measures and maintain clean claim standards across all specialties and facilities. 7: Tracked payment postings, identified missing payments, and ensured timely reconciliation with daily and monthly collection reporting. 8: Conduct monthly audits of resubmitted claims and created performance reports for continuous process improvement. 9: Maintained and updated the Quick Reference Guide (QRG) with payer-specific requirements and billing updates. 10: Provided peer support and training to new team members, fostering a collaborative and quality-focused work environment.

Responsibilities as Account Manager: 1: Review eligibility and benefits verification prior to patient appointments to ensure accurate and efficient billing. 2: I am working on obtaining prior authorization for services such as sleep studies. ▫️Use UHC’s portal for UnitedHealthcare. ▫Use Evicore for payers like BCBS NC, WellCare, and Simply Healthcare. ▫️Submit faxed forms for payers such as Cigna and HTA. Always confirm the payer’s preferred submission method. 3: Perform daily claim review and submission to guarantee timely processing and minimize delays. 4: Manage claim rejections by identifying necessary billing adjustments, maintaining the Quick Reference Guide (QRG), and coordinating updates with assigned billers. 5: Review payment postings regularly and implement strategies to improve collections and revenue cycle performance for clients. 6: Handle denial management by identifying required corrections and collaborating directly with providers to enhance claim reimbursement rates. 7: Oversee the Accounts Receivable (AR) team to ensure accuracy in follow-ups on unpaid claims, securing payments, and submitting reconsiderations or appeals in a timely manner when necessary. 8: Prepare and deliver weekly, bi-weekly, and monthly collection reports for clients to monitor financial performance and operational progress. 9: Maintain organized and accurate records and documentation to support audits and future reference needs. 10: Bank reconciliation and Two way Reconciliation every month. 11: Manage EDI enrollments with all payers through platforms such as Availity, Zelis, OptumPay, and ECHO, streamlining workflows and facilitating timely receipt of payments through ERAs. 12: Train team members and conduct quality assurance reviews to ensure smooth operations and minimize billing errors. 13: Continuously update knowledge of CPT and ICD codes by utilizing CMS guidelines and conducting independent research to maintain billing compliance and accuracy.

Responsibilities as Acting Team Lead: 1: Conduct eligibility and benefits verification before patient appointments to ensure accurate billing. 2: Perform daily claim review and submission to ensure timely processing. 3: Manage rejections by identifying billing changes, maintaining the Quick Reference Guide (QRG), and coordinating updates with assigned billers. 4: Review payments regularly and implement strategies to improve collections for the client. 5: Handle denial management by identifying necessary changes and coordinating directly with providers to enhance claim reimbursements. 6: Conduct Accounts Receivable (AR) follow-ups on unpaid claims, ensuring payments are received or, when needed, timely submission of reconsiderations or appeals. 7: Prepare and deliver weekly, bi-weekly, and monthly collection reports for clients to track performance and financial progress. 8: Maintain accurate records and documentation for future reference and audits. 9: Manage EDI enrollments with all payers through platforms such as Availity, Zelis, OptumPay, and ECHO, streamlining workflows and facilitating timely receipt of payments through ERAs. 10: Train team members and perform quality assurance checks to ensure smooth operations and minimize errors. 11: Continuously learn and stay updated with the latest CPT and ICD codes by referring to CMS guidelines and conducting independent research as needed.

Responsibilities as Account Executive: 1: Create claims and submission to ensure timely processing. 2: Working on rejections by identifying billing changes, maintaining the (QRG). 3: Payment Posting EOB's and ERA's to improve collections for the client. 4: Handle denial management and changes on claims what necessary required such as CPT, ICD-10 Etc. 5: Accounts Receivable follow-ups on unpaid claims, ensuring payments are received or, when needed, timely submission of reconsiderations or appeals. 6: Maintain accurate records and documentation for future reference and audits. 7: Continuously learn and stay updated with the latest CPT and ICD codes by referring to CMS guidelines and conducting independent research as needed.