Quality Analyst - Jorie Healthcare pvt ltd
(2023-07 - 2023-11)
- Audit daily production done by EV users and shared the audit report with the team and management.
- Conducting PKT's on monthly basis.
- Conducting training and feedback sessions to the team.
- Communicating with internal management and client about the audit results and recommendation.
- Prepare weekly and monthly quality data to share with the team and management.
- Ability to write reviews and set performance objectives.
Sr. Process Associate - Pacific BPO Pvt. Ltd.
(2022-06 - 2023-07)
- Worked on denials, make calls to the insurance services and to get the payment of the billed claim.
- Preparation of appeals and reconsideration forms and submission to insurance for payments.
Sr. Process Associate - Coronis Healthcare Pvt Ltd. - Chandigarh
(2020-10 - 2021-08)
- Worked on denials, make calls to the insurance services and to get the payment of the billed claim.
- Preparation of appeals and reconsideration forms and submission to insurance for payments.
Sr. Process Associate - Capline Dental Services - Noida
(2019-11 - 2020-07)
- Worked with the process LC3.
- Worked on live claims when patient present in the clinic for treatment, mandate to check their benefits and to let the onshore team know what's pending on patient's account.
Sr. Process Associate / Quality Analyst and Team Leader - Eli Healthcare - Faridabad
(2015-06 - 2018-09)
- Joined as a Sr. process associate. Worked on denials, called insurance reps. for claim status information, claim submission, payment posting, accounts submission charges reports.
- In 2016, Got promoted as a Quality Analyst.
- Audit functions like AR denials, Patient statement and clearing house rejection.
- Share audit reports WTD, MTD and YTD reports with the respective supervisors.
- Share audit sheet and error log with the team on daily basis.
- Provide training to new users about PMS.
- Provide feedback to the team.
- In 2017, Got promoted as Team lead
- Assigning work to the team, preparation of day end report.
- Handling client calls.
- Maintain leave and break logs.
- Sharing of performance report on individual basis with the team.
- Preparation of SOP for the client.
- Team huddles and calibration sessions.
- Handle client escalations.
