Shagun Thakur
Medical Billing Specialist @InstantServe Healthcare
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WORK HISTORY
Medical Billing Specialist @InstantServe Healthcare
Wayne, PA, US
Expert in handling intricate insurance claims, ensuring accuracy and compliance with payer requirements.• Conduct detailed verification of patient insurance coverage, obtain pre-authorizations for treatments, and ensure that all necessary documentation is in place before services are rendered.• Perform detailed reviews of medical codes for accuracy and completeness, applying specialized coding systems such as ICD-10, CPT, and HCPCS codes to complex medical scenarios.• Investigate, analyze, and resolve claim denials and rejections by appealing decisions, providing additional documentation, and working with insurance companies to secure payment.• Oversee and manage accounts receivable, including tracking overdue accounts, making collection efforts, and reconciling discrepancies in patient and insurance payments.• Ensure adherence to all relevant healthcare billing regulations and policies, including federal, state, and payer-specific guidelines, to minimize legal and financial risks.• Analyze billing data to identify trends, track key performance indicators, and generate detailed reports for financial and operational analysis.• Provide training and support to junior billing staff or new hires, offering guidance on complex billing processes, coding updates, and best practices in medical billing.
EDUCATION
Rayat Institute of engg. & Information Technology, Railmajra
Bachelor of Technology - BTech
ABOUT SHAGUN THAKUR
Experienced in managing intricate insurance claims with a focus on accuracy and compliance. I excel in verifying patient coverage, securing pre-authorizations, credentialing, and ensuring thorough documentation. Proficient in medical coding (ICD-10, CPT, HCPCS), resolving claim denials, and overseeing accounts receivable. I ensure adherence to billing regulations(for Physician, hospital, HME and DME), analyze data for performance insights, and train junior staff. Dedicated to optimizing revenue cycles and driving operational efficiency.
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