Virupakshi Navya

To obtain a challenging position where I can effectively contribute my skills as a Healthcare Professional and also to further sharpen my skills which helps me in seeking position. With extensive experience in the Healthcare BPO Industry, I feel confident that I will do well in my role and my nature of flexibility can make me work anywhere with full confidence.

Subject Matter Expert (SME) / AR Executive - Unislink India Pvt Ltd - Hyderabad, India

(2021-12 - 2024-12)

Provided mentoring, managed RCM processes, and led quality improvement initiatives.

• Provided mentoring for the new hires and reviewed claims to maintain overall team quality.
• Maintained structured trackers for new updates, ensuring team-wide awareness and accuracy.
• Spearheaded initiatives for analyzing weekly error files, collaborating with team members, and delivering final reports to supervisors.
• Managed RCM Denial Management, US Healthcare Processes, and handled multiple complex Denial Codes.
• Executed follow-up action plans from verification activities, research, and analysis workflows.
• Expertise in CMS1500 billing, claims follow-up, and managing end-to-end appeals processes.
• Contacted insurance providers via phone and online portals to secure necessary Authorizations.
• Generated AR Inactive reports and systematically allocated work orders based on priority matrix.
• Identified process gaps and implemented Corrective and Preventive Actions (CAPA) while assisting the team to meet target benchmarks and clarifying technical doubts.

AR Caller - Viewgol

(2025-01 - 2025-06)

Initiated outbound calls to insurance companies and managed claim resubmission processes.

• Initiated outbound calls to commercial and government insurance companies in the US to check the status of outstanding claims.
• Identified the root causes of unpaid, rejected, or denied claims and initiated prompt corrective action.
• Maintained clear, concise, and professional documentation of accounts and call outcomes within the billing system.
• Resubmitted corrected claims with necessary documentation (such as medical records or proof of timely filing) via clearinghouses or portals.

General Nursing Management - Nursing - Board of Examination of General Nursing and Midwifery (2021)

Intermediate - Board of Intermediate Education, Telangana, Hyderabad (2017)

S.S.C - Board of Secondary Education (2015)