Johnson R

Highly skilled and detail-oriented Senior Process Executive with 4.8 years of experience in the U.S. healthcare industry. Proficient in reviewing, analyzing, and processing medical insurance claims to ensure compliance with policy guidelines and regulatory standards. Demonstrates expertise in medical billing codes (CPT, ICD-10cm, HCPCS), healthcare regulations (HIPAA, CMS), and claims adjudication software.

Adept at resolving claim discrepancies, to healthcare providers, and delivering exceptional customer service. Committed to maintaining accuracy, confidentiality, and efficiency in claims processing to support organizational goals and enhance client's satisfaction.

Worked as a Quality Analyst in US healthcare project, performed quality audit of post-payment claims and rectified especially payment posting errors of claim processor from different vendors groups also, provided RCA, focus audit, Cross audit to improve the team’s quality scores and maintained quality metrics.

Completed B.COM General specialized in Commerce in the period of June

2016 to March 2019