Abinaya S.
Chennai
Summary
Seeking a pleasant work environment that encourages innovative thinking and provides opportunities to improve my skills and knowledge. Aiming to achieve professional success in alignment with organizational growth. Authorized to work in the US for any employer.
Overview
11
11
years of professional experience
2
2
Languages
Work History
External Quality Analyst
Holy Name Medical Center
06.2023 - Current
- Implemented new QA checklist reducing claim rework by 30%, saving 40+ weekly labor hours. Train and mentor 15+ analysts, improving claims accuracy by 25% and reducing denials by 18%. Resolve 100+ complex provider disputes quarterly through client-facing collaboration.
- US Healthcare Process
Customer Service Representative
HCL Technologies Pvt Ltd
08.2022 - 06.2023
- Handled US healthcare billing inquiries and complex case resolution. Optimized processes to reduce call resolution time by 20%. Trained 10+ new hires on RCM workflows and compliance protocols.
- Apria Project
Senior Process Associate (SME)
Cognizant Technology Solutions
08.2014 - 01.2019
- Subject Matter Expert for claims adjudication (Medical, SHP, PDR teams). Processed claims for California residents under state health programs. Managed provider dispute resolutions and medical recovery cases.
- Health Net, CA
Education
B.Sc. - Computer Science
KRMCC College
01.2014
12th Standard - undefined
Lady Wellington School
01.2010
10th Standard - undefined
Lady Wellington School
01.2008
Skills
Technical Skills
EHR Systems: Athena, Aprima, CareCloud, WebHIS; RCM Platforms: Apria, HealthNet Systems; Billing Specializations: Physician Billing (E&M Services), Hospital Billing (Inpatient/Outpatient), DME Billing (Prior Authorizations); Medical Coding: ICD-10, CPT, HCPCS, DRG, Modifiers; Claims Processing: CMS-1500 & UB-04 Forms, EDI 837 Claims Submission, Denial Management (ERA/EOB Analysis); Compliance: HIPAA, CMS Guidelines, OIG Audits; QA Tools: ClaimScrub, Navicure, Waystar
Team Leadership
Interests
Hobbies, Cooking, Volleyball
Personal Details
Name: Abinaya S.; Husband’s Name: Senthilkumar; Gender: Female; Marital Status: Married; Religion: Hindu; Nationality: Indian; Languages Known: English (Fluent), Tamil (Native)
Timeline
External Quality Analyst
Holy Name Medical Center
06.2023 - Current
Customer Service Representative
HCL Technologies Pvt Ltd
08.2022 - 06.2023
Senior Process Associate (SME)
Cognizant Technology Solutions
08.2014 - 01.2019
12th Standard - undefined
Lady Wellington School
10th Standard - undefined
Lady Wellington School
B.Sc. - Computer Science
KRMCC College