Manohar E L

Aim to be associated with a progressive organization which offers an excellent atmosphere to prove myself by utilizing all my knowledge and skills into practice and profit myself with experience and valuable knowledge for the development and growth of the organization.

Grievance & Appeals Specialist - Sagility India Private Limited

(2025-04 - 2026-04)

• Provider Disputes & Appeals: Experience in clinical appeals, provider grievance processes, and negotiating settlements with medical professionals.
• Clinical Knowledge: Ability to review medical records for severity of illness and intensity of service to challenge denial decisions.
• Contractual Expertise: Knowledge of managed care contracts, billing, and coding to identify erroneous claim denials.
• Claims Management: Claims processing, adjudicating, billing, and coding (ICD-10, CPT, HCPCS)
• Billing & Revenue Cycle: Medical billing, claim submission, denial management, aging report analysis, payment posting, and reconciliation.
• Payer Knowledge: Medicare, Medicaid, Affordable Care Act (ACA), and commercial insurance policies.

Bachelor of Arts - Arts - Govt. First Grade College, Sagara (Kuvempu University) (2024-09 - 2024-09)

HEGS (Arts) - Arts - Government Junior College, Sagara (2021-07 - 2021-07)