Muhammad Bilal A.

I've spent the last 5+ years working as a medical biller and credentialing specialist, and in that time I've recovered $2M+ in aged AR and credentialed and contracted providers, groups, and facilities, including a 70+ provider group in California. On the medical billing side, I recovered aged AR by identifying unpaid claims, working rejections and denials, filing appeals, following up with payers, and ensuring claims were submitted and processed correctly. On the credentialing side, I credentialed and contracted providers with insurance plans and IPAs, handled recredentialing and address updates, managed provider data, and led a credentialing team handling issues such as providers not appearing on payer portals, incorrect portal addresses, authorization denials, and other contracting issues while maintaining accurate provider information in MD Staff.

I started at the ground level doing medical billing work, claims submission, payment posting, and denials, basically everything an end user touches, before moving into lead and management roles where I worked directly with providers on their concerns and put together reports and summaries (you'll find some of these in my portfolio below).

I've worked across a mix of specialties: internal medicine, family medicine, mental health and behavioral health, physical therapy, rural health clinics, ambulance/EMS billing, ASAM 3.1 residential treatment facilities, and DME billing for post-mastectomy services. Every one of these comes with its own coding quirks, payer rules, and documentation requirements, so I don't run the same generic process across all of them. I adjust based on what each specialty actually needs.

Medical billing and coding services:
• Full revenue cycle management (RCM), from charge entry through claim submission on CMS-1500 and UB-04 forms
• Medical coding across ICD-10, CPT, and HCPCS, including E/M coding, modifier application, and multi-specialty coding
• Insurance eligibility and benefits verification before claims go out, so denials get caught before they happen instead of after
• Claim scrubbing and compliance reviews to reduce first-pass denials
• AR follow-up and denial management, claim appeals and denial resolution
• Payment posting and reconciliation
• Patient billing, statements, and collections

Provider credentialing and payer enrollment services:
• Individual and facility credentialing
• CAQH profile setup and ongoing maintenance
• PECOS enrollment for Medicare and Medicaid billing
• Commercial payer enrollment and contracting • Prior authorization support • Multi-state enrollment and re-credentialing • Payer follow-up through full provider onboarding