Quality Control Analyst at Healthcare Informatics Pvt Ltd (2025-07 – 2026-05)
- Conducted routine quality assessments to ensure compliance with regulatory standards.
- Maintained detailed records of inspections, tests, and corrective actions taken.
- Conducted root cause analysis for recurring issues, developing long-term solutions to prevent recurrence.
- Provided training to new hires on quality control procedures, fostering a culture of excellence within the team.
- Improved overall production efficiency by identifying and resolving quality control issues.
Senior Executive/Quality Control Analyst at Omega Healthcare Management Services Private Ltd (2022-03 – 2025-01)
- Track daily, weekly, and monthly quality trends to report to operations management, Call Monitoring and Evaluation
- Conduct one-on-one feedback sessions to help agents understand their performance gaps
- Created detailed reports on quality trends, providing insights for executive decision-making processes.
- Established key performance indicators to measure effectiveness of quality control initiatives.
- Enforce HIPAA compliance to protect patient Health Insurance Portability and Accountability Act standards.
Senior Client Partner at Access Healthcare Services Pvt Ltd (2020-10 – 2022-03)
- Validated and processed DME orders, ensuring precise documentation of certificates of medical necessity (CMN) and prescriber orders.
- Drafted and submitted Level 1 appeal/Reconsiderations letters, backed by medical necessity documentation, clinical notes, and proof of prior authorization
- Maintained an average daily call volume of 30+ Conversation with insurance representatives while maintaining a 95%+ quality score.
- Analyzed and resolved complex claim denials. Reduced aging AR buckets (greater than 90 days)
Senior Executive at Omega Healthcare Management Services Pvt Ltd (2020-02 – 2020-10)
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Demonstrated respect, friendliness, and willingness to help wherever needed.
Intern at Global Healthcare Resource (2019-04 – 2020-02)
- Mastered US Healthcare RCM fundamentals, including the life cycle of a claim, provider-patient-payer relationships, and basic medical billing terminology.
- Insurance Follow-up & Operations, Maintained a high accuracy rate in data entry while documenting claim statuses, minimizing errors in internal tracking sheets
- Organized and prepared supporting documentation, such as medical records and prior authorizations, required for the submission of clean claims and appeals.
