ALI MUHAMMAD

Medical Billing, Revenue Cycle and Credentialing Specialist

Ali Muhammad

Medical Billing, A/R and Credentialing Professional

Email: ali.muhammad.8066185@gmail.com

WhatsApp/Phone: +92 302 6945322

Location: Lahore, Pakistan (Remote Specialist)

I help US healthcare providers maximize collections, reduce denials, and ensure seamless revenue cycle operations while maintaining strict HIPAA compliance. By combining technical billing expertise with comprehensive provider credentialing, I offer a full-scale solution for practice management.

How I Can Help Your Practice

I provide end-to-end support to streamline your revenue cycle and reduce administrative burdens. My core services include:

Credentialing and Enrollment Services

I manage the complex administrative requirements to ensure your providers are fully authorized to receive payment:

* Provider Onboarding: Managing full-cycle credentialing and re-credentialing for Commercial, Medicaid, HMO, and Medicare Advantage plans.

* Profile Management: Expert maintenance of CAQH profiles and Credy App for provider data maintenance, including regular attestations.

* Technical Setup: Streamlining practice workflows through ERA, EFT, and EDI setup and electronic enrollment via portals like Echo and Availity.

* Compliance and Maintenance: Handling Medicaid revalidations, contract amendments, and fee schedule updates.

Back-End Billing and Claims Management

* Accurate Charge Entry and Claims Submission.

* Denial and Rejection Resolution and Appeals.

* Eligibility and Benefits Verification (Availity, Navinet, UHC, CMS, Tricare).

* Claim Status Follow-Ups and Resolution of Clearinghouse Rejections.

Patient and Facility Communication

* Patient Balance Collections: Professionally contacting patients to resolve outstanding balances.

* Coordination of Benefits (COB): Proactively obtaining insurance updates and resolving COB discrepancies.

* Facility Liaison: Communicating with facility staff to resolve inquiries and ensure billing accuracy for multiple specialties.

Software and Portal Proficiency

* AthenaOne: Expert in full billing cycle management.

* Kareo/Tebra: Highly proficient in standard and premium Tebra platforms.

* SmartCloud, Claims MD and Trizetto: Extensive experience with these platforms for advanced inquiry resolution and clearinghouse management.

* Portals and Tools: Availity, Tricare, Echo, and Credy App for provider data management.

* AccuMed: Valuable experience in diverse billing environments.

Why Partner With Me?

Beyond my billing and credentialing expertise, I bring a unique commitment to operational excellence and risk management, backed by:

* OSHA 30-Hour General Industry Certification: Demonstrating a high-level mindset for compliance and procedural adherence.

* IOSH Managing Safely Certification: Validating a disciplined, professional approach to managing health and safety risks within any operational environment.

Experience Highlight

ASA Billing Services LLC

October 2023 – May 2026

Credentialing Specialist (October 2025 – May 2026)

* Led provider enrollment and re-credentialing processes for multiple insurance panels.

* Maintained provider data and documentation accuracy using the Credy App and CAQH.

* Managed EDI/ERA/EFT setups and monitored contract amendments to ensure optimal reimbursement rates.

Accounts Receivable Executive (October 2023 – September 2025)

* Managed A/R and specialized billing for multiple Nephrology and multi-specialty providers.

* Specialized in resolving complex denials and executing successful appeals to recover lost revenue.

* Conducted high-volume patient calls for balance collections and insurance updates, significantly reducing aged A/R.

Let's Connect

I am available for a discovery call to understand your practice's specific pain points and outline how I can help increase your collections.

Click here to schedule a call directly: https://us05web.zoom.us/launch/chat?src=direct_chat_link&email=ali.muhammad.8066185%40gmail.com

• Achieved Revenue increase by completing Denials Resolution with accuracy and efficiency.

Results-oriented and highly motivated professional with a strong work ethic and a proven ability to exceed expectations. Possesses excellent communication, problem-solving, and interpersonal skills. Adept at navigating complex situations with composure and finding effective resolutions. Demonstrates a strong commitment to compliance and a proactive approach to learning and professional development. Thrives in fast-paced environments and effectively manages workload under pressure. Eager to contribute to a dynamic team and contribute to the success of the organization.

Document Control Specialist Certification at QLS Level 3

• Avid reader of healthcare industry publications, including Becker's Hospital Review, Healthcare Finance News, Modern Healthcare, and the Journal of the American Medical Association (JAMA).
• Follows current events in international relations and economics through articles in The Economist, Foreign Policy, The New York Times (International section), and Project Syndicate.
• Maintain an interest in industry trends by regularly reading articles from reputable sources such as the World Health Organization (WHO) website, the Centers for Disease Control and Prevention (CDC) website, and the National Institutes of Health (NIH) website.