Sr. Executive at PACIFIC BPO Pvt. Ltd. (2023-01 – Present)
Eligibility Verification – Insurance Verification. Project: US Healthcare Insurance (Medical Billing)
- Responsible for Patients Responsibilities and Member Benefit Plans.
- Following HIPAA Guidelines while working on patient eligibility and Insurance Verification where I need to identify the effective date & Termination Date of policy holder/Subscriber from the Payer Portal.
- Knowledge of Healthcare Software, JACADA, UNET, Encompass, Next Gen, Advanced MD.
- Currently working on Next Gen.
- Evaluate and Processes claims as provided SOP on the behalf of Client Side.
- Reporting of Production by using Google Sheet at Operational Level.
- Weekly Group meeting with supervisor & Quality for growth as well as Organization.
Sr. Process Associates – Insurance Verification at Assimilate solution India Pvt. Ltd. (2020-09 – 2022-10)
Eligibility Verification. Project: US Healthcare Insurance (Medical Billing)
- Knowledge of Patients Responsibilities and Member Benefit Plans.
- Responsible for verify all patient insurance that Active or Inactive with Health Benefit Details.
- Using common web Payer portal for Health Coverage Verification on such kind of portal like Availity, Optum, UHC, Health Net, Evernorth, Alameda Alliance, BRMS, UMR, Blue Shield CA where I need to crosscheck Practice Management (PM) with payer portal for health Insurance benefit and Eligibility Information.
- Verifying the Payer Portal Data whatever need to mention all the missing detail in PM for completion the Eligibility and forward for further Queues.
- Access & Evaluate all the Health benefit which acquired by Payer side like, OOP MET, DED MET CASE, PR MET CASE.
- Reporting of Production records by using Excel Sheet at Operational Level.
- Monthly meeting with supervisor for individually growth as well as Organization.
Claim Associates at United Health Group a/k/a Optum (2018-07 – 2020-08)
US Claim Admin processing. Project: US Healthcare Insurance process (Claim Admin processing)
- Claim Processing of HCFA & UB Healthcare document by given guidelines of company bases instruction.
- Maintaining Records in Excels Sheet.
- Daily Work Completion Report to supervisor.
- Follow up with Quality Analysis Team for Best Quality.
- Working on the Monthly Quality of 99% Accuracy.
- Monthly meeting with Directors for Betterment in Work For Growth of Company
Process Associates at Competent Software Pvt. Ltd. (2009-07 – 2018-02)
US Deed and Mortgage Process
- Data Analyst of Deed and Deed of Trust, Mortgage processed by given guidelines of Company Based onCore Logic.
- Knowledge of Deed, Mortgage, Foreclosure, Auction, Lien.
- Apart from this Working as Quality Analysis of Lower subordinates Files.
- Daily Work Completion Report to Shift-In charge.
- Reporting by using Excel at Operational & Client Level.
