AJMAL KHAN
AR Caller
Coimbatore
Summary
Motivated and driven professional with a strong desire to secure a challenging position within an organization that values long-term career growth and offers ample opportunities for advancement. Committed to leveraging unique abilities and skills to contribute significantly to the overall growth and success of the company. Eager to take on new challenges and make a meaningful impact in a dynamic and collaborative work environment.
Overview
9
9
years of professional experience
5
5
years of post-secondary education
2
2
Languages
Work History
CLIENT SPECIALIST
LOGIX HEALTH SOLUTIONS PVT LTD
12.2022 - 01.2025
- Worked for denials to get the payment from the insurance to the provider, when the insurance unable to pay for the claims for a reason
- Working for rejected claims which are directly hitting the clearing houses and updating correct information from verifying eligibility
- Taking the responsibilities of reports are shared to the teams like hourly production report, weekly production reports
- Updating internal error feedback reports on a regular basis to the team members
- I have taken an OJT - On Job Training to freshers & taking training section about update received from the client
- Worked for funds /transfers or adjustments if it is mentioned in the EOB for balancing the patient account
- Posted Electronic claims, Paper claims, Zero pays& Manual Payments as per Explanation of benefits
- Working from the providers behalf and get the payment for the services done by the provider to patient
- Preparing Work allocation SOD and EOD for the management about the number of claims that has been rejected for the overall clients
- Taken responsibilities like fresher training and team management with 10 members
- Enhanced customer satisfaction by addressing and resolving complex issues in a timely manner.
- Responded to all client inquiries and asked appropriate questions to facilitate resolution.
- Interacted with team members across departments to research and resolve customer issues.
CLIENT SERVICE EXECUTIVE
MEDUSIND SOLUTIONS PVT LTD
09.2019 - 12.2022
- Making call to Insurance carrier for patient insurance details and plan information
- Updating prior authorization details in Hospital software
- Verifying denial for patient claims and updating the patient claim submission
- Verifying plan information and updating the Hospital software about the patient plan information
- Maintaining TAT for the Doctor appointments for Dental clinics
- Providing knowledge transfer for fresher and experienced in their training period
- Ensured timely execution of client requests by coordinating effectively with internal departments and external partners.
- Developed and maintained existing client relationship and developed new client relationships.
TRANSACTION PROCESSING ASSOCIATES
ACCENTURE SOLUTIONS PVT LTD
10.2015 - 12.2018
- Worked for denials and properly set follow up for the claims, further action, end to end navigation on a website of all type of carrier
- Updating online submission of claims, uploading medical records through website
- Updating patient information in Network management system and NASCO
- Worked for RX claims reports for updating patient information and Insurance carriers
- Maintaining Team work allocation and maintaining EOD report
- Verifying and updating patient insurance details for newborn babies
- Assisted clients with accurate eligibility form, application and document completion.
- Scheduled appointments with applicants to gather information and explain benefits processes.
- Contributed to the design and implementation of automated solutions for streamlining complex transaction processes.
Education
BCA - Computer Application
Sri Krishna Arts And Science College
Coimbatore 05.2012 - 04.2015
Secondary School -
Vidya Vikasini Higher Secondary School
Coimbatore 04.2011 - 03.2012
Higher Secondary -
Vidya Vikasini Higher Secondary School
Coimbatore 04.2009 - 03.2010
Skills
- Dedicated and Hardworking
- Adaptable and friendly
- Committed Toward Work and Team player
- Eager to learn new things
- Flexible to work in any shift
- Performance tracking
Accomplishments
- Maintained highest Productivity and Quality
- Knowledge transfer and team management
- Best performer award by Accenture
- Training for Time Management and Customer WOW Experience provided by Accenture
- Got Star Performer award in Medusind For 3 Months
- Maintaining process updates and process guidelines
Computerliteracy
VMWare, MS Office
Personal Information
- Father's Name: S.Tajuddin
- Mother's Name: T.Niloper
- Date of Birth: 10/06/94
- Gender: MALE
- Nationality: INDIAN
- Marital Status: MARRIED
Disclaimer
I hereby declare that above mentioned information is genuine best up to my knowledge.
Timeline
CLIENT SPECIALIST
LOGIX HEALTH SOLUTIONS PVT LTD
12.2022 - 01.2025
CLIENT SERVICE EXECUTIVE
MEDUSIND SOLUTIONS PVT LTD
09.2019 - 12.2022
TRANSACTION PROCESSING ASSOCIATES
ACCENTURE SOLUTIONS PVT LTD
10.2015 - 12.2018
BCA - Computer Application
Sri Krishna Arts And Science College
05.2012 - 04.2015
Secondary School -
Vidya Vikasini Higher Secondary School
04.2011 - 03.2012
Higher Secondary -
Vidya Vikasini Higher Secondary School
04.2009 - 03.2010
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