Logeshwaran Arjunan Kalaiselvan

Insurance Preauthorization and Claims Management:

• Supervised the entire process of insurance preauthorization, claims submission, and payment collection within the agreed credit period.
• Coordinated with insurance companies to secure initial approvals, facilitating patient enrollment into cashless treatment facilities.

Patient Counseling and Claim Eligibility:

• Provided clear advice to patients regarding claim eligibility based on policy terms, diagnosis, and sum assured.
• Addressed and explained claim denials, offering guidance on reimbursement processes where applicable.

Accounts Management and Aging Reports:

• Monitored monthly aging reports to track unpaid claims, following up on unsettled amounts to resolve backlogs.
• Raised indemnity bonds as needed based on situational requirements.

Insurance Validity and Patient Information Accuracy:

• Ensured accurate patient information, insurance validity, provider details, policy period, and PED (Pre-Existing Diseases) declarations for seamless cashless treatment processing.

Financial Reporting and Issue Resolution:

• Reviewed accounts receivable reports, disallowance analyses, and write-offs monthly to identify and rectify issues promptly.
• Reported findings to the central corporate team and facilitated solutions for new customer tie-ups.

Tariff Updates and Discount Control:

• Annually updated tariffs and controlled discount mechanisms to support the hospital's financial growth and sustainability.

Agreements and TPA Coordination:

• Managed agreements with corporate clients and individuals, ensuring smooth processing with Third-Party Administrators (TPAs).
• Acted as the liaison between individual customers and insurance providers, addressing concerns effectively.

Payment Adjustments and Acknowledgments:

• Reconciled daily payments, ensuring proper acknowledgment from customers.
• Adjusted payments considering TDS and obtained email confirmations for corporate/TPA settlements.

Training and Team Development:

• Conducted training sessions for new employees on admission, discharge, and billing processes.
• Organized case study programs to enhance problem-solving skills, boosting the team’s overall efficiency and enthusiasm.

• Data collection, billing verification, and corrections.
• Managing bill dispatch and claims for government and private sectors, adhering to tariff rates.
• Preparing weekly corporate client reports and MIS (e.g., debtors follow-up, revenue calculation).
• Handling petty cash, payments, receipts, and patient refunds.
• Monitoring NEFT/RTGS transactions and debt aging.
• Overseeing bill cancellations, concessions, and outstanding recoveries.
• Managing credit accounts (general, employee, doctor) and reimbursement claims.
• Coordinating agreements with ECHS, CM scheme, and Kauvery Hospital, including bill uploads and follow-ups.
• Preparing disallowance reports and resolving discrepancies.
• Supporting audits with billing details, Tally, and reconciliation reports.
• Leading a team for daily processes.

• General Ledger Accounting
• Account Analysis and Reconciliation of G/L accounts
• Month, Quarter & Year-end Close
• Expense Reporting and Analysis
• Accounts Receivable / Accounts Payable
• Financial Statements Preparation & Analysis
• Documents financial transactions by entering account information