Priya Jagtap

Motivated and detail-oriented Medical Billing Executive with hands-on experience in claims processing, denial management, appeals, and eligibility and benefits verification.

Background in operations, documentation, reporting, data entry, and process coordination, with a track record of maintaining accurate records and supporting cross-functional teams. Strong working knowledge of medical billing, insurance claims processing, denial management, and US healthcare revenue cycle processes. Strong communication, organizational, and computer skills with a commitment to accuracy and process improvement in the medical billing industry.

Medical Billing Executive (Internship) - Nexus Corporate Training Institute - Pune

(2026-03)

• Verified claim status and reviewed EDI reports to identify claim rejections and processing errors.
• Conducted eligibility and benefits verification prior to claims submission.
• Followed up on unpaid and no-response claims and reworked denied claims for resubmission.
• Requested and reviewed EOBs (Explanation of Benefits) to reconcile claim payments and denials.
• Submitted medical records and supporting documentation to insurance companies as required.
• Prepared and submitted appeals with supporting documentation for denied and underpaid claims.
• Processed patient billing and statements when balances were patient responsible.
• Maintained accurate billing documentation and recorded after-call actions for claim files.
• Performed pre-call and post-call analysis to support timely claims resolution.
• Resolved billing-related inquiries, requests, and complaints from patients and insurers.

Software Engineer - Harbinger Systems Pvt. Ltd. - Pune

(2023-01 - 2023-12)

• Monitored production servers, applications, and system performance.
• Created and maintained operational documentation and standard operating procedures (SOPs).
• Performed root cause analysis for production incidents.
• Participated in on-call support and operational escalation handling.

Operations Manager - IDFC First Bharat Ltd. - Beed

(2021-02 - 2022-12)

• Managed day-to-day operational activities and maintained accurate documentation and records.
• Maintained office supplies inventory and ordered supplies as needed, optimizing cost efficiency.
• Communicated with internal teams to ensure timely completion of operational activities.

MBA - Operations Management - Dr. Babasaheb Ambedkar Marathwada University (2025)

Bachelor of Engineering - Dr. Babasaheb Ambedkar Marathwada University (2015 - 2019)