Saurav Sharma

Prepared and submitted medical claims to insurance payers (Commercial, Medicaid, Medicare Advantage, HMO) with complete detail and high accuracy. Reviewed patient charts and ensured correct demographic, insurance, and charge details before billing and applied appropriate CPT codes, ICD-10 codes and modifiers to generate quality completed claims. Ensured timely submission of claims in accordance with guidelines and identified and corrected errors to improve first-pass acceptance rate.

Billing - RBD Billing Company - Remote

(2025-08)

• Prepared and submitted medical claims to insurance payers (Commercial, Medicaid, Medicare Advantage, HMO) with complete detail and high accuracy.
• Reviewed patient charts and ensured correct demographic, insurance, and charge details before billing and applied appropriate CPT codes, ICD-10 codes and modifiers to generate quality completed claims.
• Ensured timely submission of claims in accordance with guidelines and identified and corrected errors to improve first-pass acceptance rate.
• Coordinated and communicated interdepartmentally with multiple organization teams (Accounts Receivable, Coding, and Registration teams) to resolve errors and share updates.
• Reviewed claim edits via Clearinghouse (Experian health ClaimSource), Insurance Portals (UHC, CountyCare, Availity, etc.), and Billing Software (Star, Cerner, Passport OneSource) to resolve issues prior to claim submission.

Account Receivables - RBD Billing Company - Remote

(2025-06 - 2025-07)

• Complete insurance eligibility verification for patients across multiple payer types (such as Medicaid, Medicare Advantage, and HMO plans) for compliance with HIPAA guidelines and organizational policies.
• Perform Accounts Receivable follow-ups by checking claim status via insurance portals and client calls.
• Assess claims extensively for denial management, identifying reasons for denials and taking appropriate actions for resolutions.
• Contact insurance companies and patients to resolve any claim issues, payment delays, and discrepancies to completely resolve claims before submission.
• Ensure Coordination of Benefits (COB) by verifying and updating primary/secondary insurance details and following up on outstanding claims to ensure timely reimbursement and reduce AR aging.
• Utilize multiple insurance portals and systems to track and update claim information.
• Maintain and update daily work reports in Excel, ensuring account tracking of accounts worked and completed, and any follow ups required.
• Provide daily status updates to managers and team on productivity rate, pending issues and participate in team meetings to contribute process improvements and workflow resolutions. Collaborate with internal teams to resolve claim related issues and improve collections rate.

Account Receivables - Care Point Health - Remote

(2024-10 - 2025-03)

• Resolved denials and payment posting within given time frames and deadlines and performed Insurance review and client calling to resolve any matters relating to client accounts.
• Completed insurance eligibility verification for patients across multiple payer types.

Bachelor of Computer Applications - Himachal Pradesh University (2020 - 2023)