Aditya Jaykumar Vishwakarma

• Collected, verified, and maintained provider documentation (licenses,

certifications, DEA, etc.) in compliance with federal and payor requirements.

• Managed and completed provider CAQH profiles and ensured accuracy

across credentialing databases.

• Submitted credentialing applications t o payors, tracked progress and

conducted timely followups to prevent delays.

• Reviewed contracts for accuracy against client parameters and facilitated

execution of finalized agreements.

• Maintained provider records and enrollment data across key portals

(Availity, Optum express, PECOS, etc.)

• Supported AR team by resolving credentialing related denials with verified

in-network status documentation

• Assisted in training new staff on credentialing procedures and policies.
• Monitored expiration dates of licenses and certifications for timely renewals.

• Reviewed and investigated denied claims, identifying root causes (e.g., coding issues, authorization errors), and resolved issues through re-submission or appeals.
• Generated reports on denial trends and AR aging, providing actionable insights to management to help improve overall revenue cycle efficiency.
• Worked closely with billing, coding, and provider teams to ensure accurate claim submissions, documentation, and timely resolutions.
• Trained new hires, share Process updates, Solve worked related queries including authorization requirements, denial management procedures, and AR follow-up protocols

• Followed up with insurance companies to resolve claims and ensure timely reimbursements.
• Submitted claims, addressed pending records and EOB statuses, and maintained billing accuracy.
• Reviewed invoices, analyzed EOBs, and resolved credit balance claims in compliance with protocols.