Ashwini Jadhav

I am looking for a challenging job with a rapidly growing organization that can provide me with a range of goals and job objectives within a contemporary and economical business setting.

Senior Medical Billing Executive (RCM) - R systems International Limited

(2025-05)

I initially joined the company as a Claims Manager. Based on my performance, I was subsequently given responsibility to internally audit my POD accounts, specializing in billing.

• Internal auditor(Claims Specialist)
• Working with ABA therapy client billing charges
• Subsequently along with billing we handle Rejections as well as denial, to ensure correct billing in timely filling limit

Insurance Claims examiner (autoadjudication) - Illumifin

(2023-02 - 2025-04)

• Reviewing long term care healthcare claims from different states of USA.
• Review the policy kit and based on documented benefits pay the benefits claimed.
• Responsible for answering queries by reviewing claims rules and flow work
• Auto adjudication of claims based on all claim submitted.
• Cross checked the information provided, validate the information and passing the claim under rules and regulations.
• Paying benefits to Policy holders as per the benefits term and conditions

Claims Specialist - SS&C DST Worldwide Service

(2022-04 - 2023-01)

• Review document related to the healthcare claims from different states of US.
• Responsible to determining accurate payment criteria for clearing pending claims based on defined policy kit and procedural guidelines
• Resolve the claims issue that requires adjustment.
• Responsible for answering queries by reviewing claims rules and workflow.
• Complete all assign work within defined timeline
• The payment reimbursement to the claimant.

Lab assistant - JAY BIOTECH LMT, Nashik.

(2019-08 - 2020-02)

• Isolation, production optimization and characterization of invertase by Aspergillus Niger using fruit peel waste as substrate.
• Immobilization of enzymes.
• Dialysis/ Purification
• Extraction of DNA/RNA
• Phytochemical Characterization

Msc - Biochemistry - Pune university (2020)

Bachelor - Education - Pune University (2017)

Bsc - zoology - Pune (2015)

Secondary Certificate - K.V Sangathan, CBSE board (2012)

Secondary School Certificate - K.V Sangathan, CBSE board (2010)