Abi Jaya

Proactive and detail-oriented Senior Process Associate with nearly 3 years of hands-on experience in US Healthcare DME and Physician Billing, accounts receivable, and denial resolution. Driven by a genuine passion for untangling complex billing hurdles, I take pride in collaborating closely with cross-functional teams, reducing claim rejections, and ensuring smooth, accurate financial operations. Looking to bring my strong BCA analytical background, adaptive problem-solving mindset, and steadfast dedication to a growth-oriented organization where I can streamline billing workflows, maximize revenue recovery, and support continuous team success.

Senior Process Associate - Prochant Healthcare Solutions - Coimbatore, India

(2023-03 - 2026-01)

• Managed the complete end-to-end billing lifecycle for DME (Durable Medical Equipment) and Physician Billing (CMS-1500 / 837P), ensuring all claims were submitted accurately, compliant with payer rules, and paid without unnecessary delay.
• Evaluated physician and supplier claim denials (e.g., medical necessity, bundling, and modifier errors), filing successful redeterminations and appeals to accelerate AR recovery.
• Handled patient eligibility verification and prior authorizations proactively across DME and physician specialties, catching missing details early to prevent high-volume claim rejections down the line.
• Investigated, analyzed, and successfully resolved complex Accounts Receivable (AR) denials, directly communicating with insurance payers to appeal rejections and recover outstanding revenue.
• Conducted thorough internal quality audits across daily billing logs to maintain strict SLA compliance, ensure high operational accuracy, and uphold full regulatory adherence.
• Supervised daily Account Allocation workflows, guiding team members on high-priority tasks and balancing daily workloads to maintain fast, efficient processing turnaround times.
• Partnered closely with cross-functional team members and leadership to troubleshoot recurring systemic billing issues, share actionable best practices, and continuously improve team efficiency.

Bachelor of Computer Applications - BCA - Bishop Appasamy College of Arts and Science (2018 - 2021)

Higher Secondary Certificate - 12th Grade - Presentation Convent Girls Hr. Sec. School (2018-04)