Kailash Chand

Seeking an environment where my skills and knowledge can be shared and enriched to work in a progressive work culture and always be an asset to the organization I work with.

Senior Operation Analyst - HealthRecon Connect LLC

(2024-07 - 2025-06)

HealthRecon Connect LLC provides technology-enabled revenue cycle management solutions to US healthcare providers

• Working for medical billing
• Working in cash posting on eobs and posting payments of different claims as per eobs
• Working on recoupments and pulling eobs of different payers and working on zero-pay remittance
• Working on epars requests, efts and dashboards
• Attending client calls and resolving their queries
• Giving training to new employees

Senior Operation Analyst - R1RCM

(2019-10 - 2024-06)

R1RCM is a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers. It works in RCM.

• Working for medical billing
• Working in cash posting on eobs and posting payments of different claims as per eobs
• Working on recoupments and pulling eobs of different payers and working on zero-pay remittance
• Working on epars requests, efts and dashboards
• Attending client calls and resolving their queries
• Giving training to team members and new employees

Claim Examiner 2 - Calibrated Healthcare - Gurgaon

(2018-12 - 2019-09)

Calibrated Healthcare is a healthcare company. It works in healthcare administration and medical management, and taking care of various aspects such as claim adjudication, benefit, eligibility/enrollment and claim review.

• Working on ub claims and ub project
• Making adjustments on claims
• Working on new claims (like inpatient and outpatient)
• Looking after pay/deny or pend the claims

Back-End Senior Executive - UnitedHealth Group, Inc

(2016-07 - 2018-11)

UnitedHealth Group Inc. is a well-known American managed health care corporation based in Minnetonka, Minnesota. It is 6th in the United States on the Fortune 500. UnitedHealth Group offers products and services through two operating businesses, UnitedHealthcare and Optum, both subsidiaries of UnitedHealth Group. Optum is a new business brand of UnitedHealth Group and operating business and Business Process Outsourcing (BPO) services.

• Working as back-office executive for healthcare services
• Listening and audit the calls, grievance and grade the documentation created by CSR on these calls
• CSR work on calls from the members enrolled in different plans in the company and creating documentation on member grievances
• Attending audit calls and making ensure member concern resolved or not
• Processing in-patient hospital claims with revenue, CPT and modifiers code with the help of process instructions
• Updating the rules of knowledge central

Back-End Executive - Exl Services - Noida

(2012-05 - 2016-06)

Exl Services, US headquartered entity, is a leading provider of outsourcing services like insurance, banking and financial services, transportation and travel etc. to multiple industries. Its customizes its solutions to improve the economics business performance, transform the organizations to be learner and more flexible and provide a competitive edge in the marketplace.

• Working as back-office executive for banking & financial services
• Calculating fraud amount customer making on their accounts and closing their accounts and adding all their fraud incident details like fraud amount, customer name, customer account, fraud transactions, fraud checks in client software
• Working on customer disputes on debit and credit cards and investigating card frauds and resolving issues
• Performing activities like Data Analysis, Client Reporting etc.
• Handling client interaction
• Daily Reporting (Internal & Client)
• Support Operation & Process Excellence Team
• Conducting presentation sessions for new advisors in operations
• Giving training for new joiners in the process
• Working on Mortgage, preparing customer information based on legal notice

10th Standard - CBSE

12th Standard - CBSE

B. Sc - Graduation - Delhi University

Post Graduate Diploma in Computer Application - PGDCA - Delhi University