Fateh Najeeb

Dedicated healthcare professional with 10+ years' experience in claims assessment, denial management, and medical information review. Skilled at reviewing complex documentation, applying rules-based decision-making, and communicating outcomes clearly. Proven ability to manage high volumes, meet strict deadlines, and work across multiple digital systems. Excited to bring strong analytical judgement and a client-focused approach to ACC as a Claim Assessor.

Sr. Claims Executive at Corro health (2021-02 – Present)

Client – Change Healthcare

• Reviewed 1,000+ healthcare claims monthly against payer policies, medical documentation, and regulatory guidelines to determine eligibility and payment decisions.
• Resolved complex billing discrepancies by reviewing patient accounts, insurer payments, and contractual adjustments.
• Made independent decisions on account corrections, ensuring compliance with internal policies and external payer rules.
• Managed high-volume queues of pending accounts, consistently meeting monthly resolution targets.
• Made complex cover-style determinations on denied or underpaid claims, analysing medical notes, procedure codes, and patient history to decide whether to appeal or adjust.
• Deliver training sessions on evolving healthcare regulations and auditing best practices to enhance team productivity.

Sr Associate at Wipro (2018-08 – 2021-01)

Client – Change Healthcare

• Investigated underpayments and denials, gathering information from providers, insurers, and medical records to determine correct course of action.
• Applied contractual and regulatory rules to make sound decisions on claim adjustments and appeals.
• Identified trends in denials and recommended process improvements, reducing repeat denials by 20% in one year.
• Collaborated with clinical staff to clarify medical information before making coverage decisions.
• Tracked, analyzed, and interpreted trends in large datasets, leading to improved operational efficiency.
• Prepared clear written determinations for internal and external stakeholders, explaining rationale in plain language.

Sr. Process Consultant at Hinduja Global Solutions (2015-06 – 2018-08)

Client – LabCorp

• Integrated and maintained healthcare data from diverse sources, enhancing data accuracy.
• Assisted in transforming raw health data into meaningful insights for strategic planning, contributing to reduction in operational costs.
• Managed data analytics requests, exhibiting project management and communication skills.
• Assisted in developing strategic plans based on data analysis, enhancing critical thinking skills.
• Supported senior analysts in the collection and analysis of healthcare data, resulting in the identification of key areas for improvement in patient care.
• Assisted in the development and implementation of data management protocols, contributing to an increase in data retrieval speed.
• Created and maintained comprehensive data reports that were utilized by hospital administrators to make informed decisions, improving overall strategic planning.

BTech in Computer Science Engineering (2011-15)