Quality Control Analyst - Omega Healthcare Pvt Ltd.
(2025-07)
- Perform daily audits of billing and clinical documentation to ensure accuracy, completeness, and regulatory compliance.
- Conduct weekly Quality Assurance Testing (QAT) to validate workflow adherence and identify process gaps.
- Execute PKT reviews twice monthly to assess key performance touchpoints and monitor quality trends.
- Lead internal and external client calibration sessions weekly to align evaluation standards and reduce inter-rater variability.
- Produce daily consolidation and operational reports summarizing audit findings, trends, and corrective action status for management and clients.
Quality Analyst - Pacific (Access) Healthcare Solution Pvt Ltd
(2024-02 - 2025-07)
- Daily Audit: Conducted daily audits of team performance to ensure adherence to quality standards and compliance with established processes. This involved reviewing a sample of completed tasks, identifying areas for improvement, and providing immediate feedback to team members to enhance their performance.
- Feedback Analysis Coaching Training (FACT): Implemented the FACT program daily, which involved analyzing feedback from audits and coaching team members based on their performance.
- Quality Audit Training (QAT): Facilitated Quality Audit Training sessions twice a week to reinforce quality standards and best practices among team members.
- Process Knowledge Test (PKT): Conducted Process Knowledge Tests twice a month to assess team members' understanding of processes and procedures.
- Update Tracker: Prepared and updated an update tracker to monitor changes in processes, policies, and training materials.
- Monthly Training: Organized and conducted monthly training sessions to cover new topics, refresh existing knowledge, and introduce any updates in procedures.
- Certification: Managed the certification process for team members, ensuring they met the necessary criteria and standards.
- Audit Reports: Prepared individual daily, weekly, and monthly audit reports to track team performance and quality metrics.
- Audit Rework Report: Created audit rework reports to document instances where team members needed to correct their work based on audit findings.
- Allocation Tracker: Maintained an allocation tracker to monitor the distribution of tasks and responsibilities among team members.
- Daily Quality Tracker (DQT): Prepared a daily quality tracker to monitor quality metrics in real time.
- Q&A Calls: Attended Q&A calls to address questions and concerns from team members regarding processes, quality standards, and performance expectations.
- Client Calls: Participated in client calls, including calibration sessions, training discussions, and updates on new processes.
Sr Account Receivable - GEBBS Healthcare Solution Pvt Ltd
(2021-08 - 2024-02)
- Claim handling and denial management, Need to check claim status on behalf of doctor's office and if claim is denied then need to follow with insurance company for claim resolution, End to End process, Need to create appeal if needed to process the claim.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Adaptable and proficient in learning new concepts quickly and efficiently.
- Proved successful working within tight deadlines and a fast-paced environment.
- Demonstrated strong organizational and time management skills while managing multiple projects.
- Claim resolution and mainly focusto reduce 360+ AR which is hitting weekly inventory, Inventory mapping and helping people to better understand AR knowledge & denials, handling multiple sub projects of Forefront end to end.
- Claim Gateway EDI rejection or Emdeon Rejection, Eligibility/Benefits Verification, Appeals & Claim Edits & payment posting.
- Payment posting & W9 form submission.
Process Associate - Datamark BPO Service Pvt Ltd
(2018-10 - 2021-06)
- Entering and verifying tracking details, bills of lading, and freight documentation.
- Handling research, resolving flagged shipment cases, and updating records.
- Checking shipment data accuracy and escalating or closing files based on system rules.
- Trained new associates on best practices, boosting team performance.
- Conducted regular audits, maintaining high standards of operational integrity.
