Senior Operation Analyst - Health Recon connect
(2023-10)
US Healthcare Collections
- Follow up on submitted claims, monitor unpaid claims, and identifies underpaid and non-billed claims with appropriate corrections and documentation
- Reviewing EOB/ERA denials and Patient history notes to understand and resolve denial on a claim
- Follow up with insurance carriers for the status of outstanding claims and receive payment information if the claims have been processed
- In case of rejections, analyze the claims
- Ensure deliverables adhere to quality standards and maintain adequate documentation on the client software to send the necessary documents to insurance companies and keep an audit trail for future reference
- Record post-call actions and perform a post-call analysis of the claim follow-up
Team Lead (Charge Scrubbing) - Wecare Healthcare Solutions
(2022-03 - 2023-09)
US Healthcare operations
- Overseeing daily Billing Department functions, including Charge Scrubbing, charge entry, reimbursement
- Responsible for supervising the team to work on assigned cases for professional and Institutional Claims
- Monitor Team's production and SLA delivery
- Keep a record of client KPIs and team's performance against the KPIs
- Experience in RCM large volume End-to-End Billing and Denial Management
- Knowledge of various billing systems / End-to-End Process flow / Accounts Receivable followup / Industry Benchmark on KPI / Productivity / Quality / HIPAA
AR Analyst - Founders Health
(2021-01 - 2022-02)
US Medical Billing
- Following up and resolving outstanding aged AR accounts using various research methods including phone calls to the payer and appeals through online insurance portals to maximize reimbursement
- Obtaining referrals and pre-authorizations as required for procedures
- Checking eligibility and benefits verification for treatments, hospitalizations, and procedures
- Analyzing and submitting appropriate documentation based on payer requirements
Accounts Receivable - Dafsons Health Care
(2019-05 - 2020-09)
US Medical Billing
- Following up on unpaid claims within standard billing cycle time frame
- Obtaining referrals and pre-authorizations as required for procedures
- Checking eligibility and benefits verification for treatments, hospitalizations, and procedures
- Researching and appealing denied claims
Process Executive - SKYCLIFF IT Pvt Ltd
(2017-09 - 2019-01)
US Medical Billing
- Checking eligibility and benefits verification for treatments and hospitalizations
- Answering all patient or insurance telephone inquiries pertaining to assigned accounts
- Reviewing accounts for insurance of patient follow-up
- Maintaining insurance authorizations for new and current patients
Admin Assistant - Adecco
(2014-07 - 2017-06)
The Hindu - India's National Newspaper
- Overseeing administration activities including office facilities
- Establishing and maintaining files & records for the office
- Coordinating with the clients to answer all the queries and ensure complete customer satisfaction
Customer Service Executive - First Source Pvt Ltd
(2011-08 - 2013-09)
- Handling incoming calls from customer
- Assisting customers effectively by solving customer disputes
- Handling customer inquiries, complaints, billing questions and Service requests
- Offered new services based on the needs of the customer
