Abhilash Sharma (Medical Billing Specialist)
Ghaziabad Tehsil
Summary
Experienced medical billing professional with expertise in inpatient, outpatient, and physician billing. Skilled in accurately filing claims, resolving rejected claims, and navigating insurance contracts, appeals, and EOB's. Proficient in quality control reimbursement and implementing process improvements for enhanced accuracy across business, medical records, and billing departments.
Overview
7
7
years of professional experience
Work History
Quality Assurance Analyst
[MD EVERYWHERE PVT LTD]
Noida
07.2021 - Current
- Conducted internal audits to ensure compliance with quality standards.
- Developed and maintained audit plans, checklists and procedures.
- Evaluated production processes for efficiency and effectiveness.
- Collaborated with production staff to resolve quality issues in a timely manner.
- Provided guidance to team members on the implementation of corrective action plans.
- Highlighted compliance issues for management team.
- Laid out suggestions to improve quality controls and operations standards.
Senior Analyst
[PACIFIC BPO PVT LTD ]
Noida
06.2019 - 05.2021
- Focused on efficient handling of denial issues within accounts receivable operations
- Investigated claim denials for underlying issues
- Solved account discrepancies by coordinating efforts across departments.
- Addressed and resolved client's issues related to payment denials.
- Implemented plans for better efficiency in payment collections.
Analyst
[MD EVERYWHERE PVT LTD]
Ghaziabad
02.2018 - 03.2019
- Investigated and analyzed denied claims to determine reasons for denial and implemented corrective actions.
- Collaborated insurance companies, and internal billing teams to resolve claim denials.
- Developed and executed strategies to reduce the denial rate and improve the reimbursement process.
- Monitored trends in claim denials and provided insights to management for process improvement.
- Guaranteed adherence to regulatory standards and company guidelines in denial management processes.
Education
B.COM -
Delhi University
01.2014
Higher Secondary -
CBSE Board
01.2011
Secondary School -
CBSE Board
01.2009
Skills
- Revenue Cycle Management
- Payment Reconciliation
- Claims Processing
- Insurance Verification
- Claims Auditing
- Understanding of Insurance Policies
Hobbies and Interests
- Travelling
- Cooking/Baking
- Reading
- Video Games
Timeline
Quality Assurance Analyst
[MD EVERYWHERE PVT LTD]
07.2021 - Current
Senior Analyst
[PACIFIC BPO PVT LTD ]
06.2019 - 05.2021
Analyst
[MD EVERYWHERE PVT LTD]
02.2018 - 03.2019
B.COM -
Delhi University
Higher Secondary -
CBSE Board
Secondary School -
CBSE Board
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