Hi, I’m
Anoop Kumar
Senior AR (Hospital Billing )
Gurugram,haryana
Summary
To acquire a rewarding and responsible position in a growth-oriented company where excellent analytical and technical skills can help to improve company’s profitability. Proven skills in managing teams to work in sync with the corporate set parameters & motivating team for the achieving business and individual goals.
Overview
11
years of professional experience
6
years of post-secondary education
Work History
Cosentus Business Service, CIPL, Gurugram , Haryana
Sr. Account Receivable (Hospital Billing)
11.2022 - Current
Job overview
- I have 10 years of experience in medical billing (hospital billing )
- I have good knowledge of UB04, cms1500, Medicare, Medicaid, billing, TriZetto, Rejection Managing escalations for the center and providing effective resolutions
- Conduct team huddles do monthly and weekly review
- I follow all interaction of my respective manager’s
- I have good experience on RCM denial
- Worked on denial claims (Capitation, Coverage terminated, Duplicate Claim, Medically not necessity, Missing/Invalid Diagnosis code, No authorization, Past timely filing, This care may be covered by another payer per coordination of benefits) To prioritize the pending claims for calling from the aging basket
- Coach new team members Identifies development areas and helps the individuals and the team to improve their performance and enhance their potential And Audit user’s claims for internal quality and external quality.
- I have more knowledge about healthcare applications (EDI, Citrix, Allscripts, Omega, CPW
- Medics, CMP, change healthcare, Cosmos, client share points)
- I have IT skills for helping new team members
- I have good experience with excel, SQL.
Wipro Limited, gurugram
Associate Hospital Billing
2021.12 - 2022.11 (11 months)
Job overview
- Investigate the reason for every denied claim , Focus on resolving the issue, Resubmit the request to the insurance company File appeals where required .
- Working on Correspondence EOB
- Insurance calling, Eligibility Verification, follow up on appeals
- Create proper note for future follow up
- Perform pre-call analysis and check status by calling the payer or using IVR or web portal services
- Monitor all outstanding balances on denial cases
- Identifying the root cause for claim denials is one of the important processes in Accounts
- Worked on denial claims Initiate telephone calls to insurance companies requesting the status of claims in the queue
- Monitor all patient demography error and eligibility and verification
- Worked with new team members resolve the Global query
- Audit claims for internal quality and external quality
- Working on aged inventory and resolving pending case posting cases
- I have good knowledge about advanced excel.
EMD-s INDIA PRIVATE LIMTED, Noida
Claim Associate Hopital Billing
2021.03 - 2021.12 (9 months)
Job overview
- Maintaining the billing system Monitor all outstanding balances on denial cases.
- I audit claim for team quality and maintain internal quality dashboard
- Monitor all outstanding balances and collection options to negotiate collections
- Identifying the root cause for claim denials is one of the important processes in Accounts
- Following up on the AR on a timely basis is very important for uninterrupted cash flow
- Accounts Receivable management team will keep track of all claims that have been filed.
- Also, it will execute an action plan immediately if the claims are not paid within the 30-day time limit
- Initiate telephone calls to insurance companies requesting the status of claims in the queue
- I have good knowledge about healthcare application
- Monitor all patient demography error and eligibility and verification
- Work with new team member resolve the Global query
- Worked on aged inventory and resolve pending cases.
- Maintain records of all benefits and resolve all issue in claim processes
- Coordinated with respective team leader for correct correction.
R1 RCM global private Ltd, Noida
Senior Analyst HB
2019.01 - 2020.12 (1 year & 11 months)
Job overview
- I do make call to the insurance company for patient plan, and I check copay, co-insurance, deductible, If the payment is not received, follow up on the calls to secure payments
- Discuss with insurance company for patient payment
- Contact Client Agents to obtain or correct diagnosis or procedure information, Send Dunning letters and emails to the customer
- If the payment is not received, follow up on the calls to secure payments, resolve any issues and discrepancies in the claim by contacting various parties and resubmit the claims
- Worked on denial claims (Capitation, Coverage terminated, Duplicate Claim, Medically not necessity, Missing/Invalid Diagnosis code, No authorization, Past timely filing, This care may be covered by another payer per coordination of benefits) Monitor vital signs and patient demographic details.
- I do work on auth claims and pending denial claim
- Worked on email cases for patient collection payments
- Manage all insurance transactions.
United Health Group, (optum Global Solutions), Noida
Claim Associate ( PB ,HB )
2013.01 - 2018.12 (5 years & 11 months)
Job overview
- Connecting with our Client’s business partners in united health insurance
- Follow up on outstanding account and pending cases
- I do check patient Responsibility copay, co-insurance, deductible
- Analyzing medical insurance claims for Quality assurance
- I do appeals if provider is not satisfied with the denial reason..
- I used to apply critical thinking and critical decision making for completing transactions.
- Checked all claim details and policy information and investigate all details for insured
- Investigated Maintain records of all benefits and resolve all issue in claim processes
- Coordinated with respective team leader for correct correction
- Maintaining the billing system Following up on the AR on a timely basis is very important for uninterrupted cash flow
- A good
- Accounts Receivable management team will keep track of all claims that have been filed
- Also, it will execute an action plan immediately if the claims are not paid within the 30-day time limit
- The team will also ensure that there is no underpayment or overdue payment
- Initiate telephone calls to insurance companies requesting the status of claims in the queue
- I have good knowledge about healthcare application
- Monitor all patient demography error and eligibility and verification
- Work with new team members resolve the Global query
- Worked on aged inventory and resolve pending case posting cases
- Maintain records of all benefits and resole all issue in claim processes
- Coordinated with respective team leader for correct correction
- Worked on denial claims (Capitation, Coverage terminated, Duplicate Claim, Medically not necessity, Missing/Invalid Diagnosis code, No authorization, Past timely filing, This care may be covered by another payer per coordination of benefits)
Education
Kanpur University , Uttar, Pradesh
Bachelor of Arts from English Literature
2008.07 - 2011.11 (3 years & 4 months)
UK Inter collage , Uttar, Pradesh
Secondary Examination – Class XII
2007.01 - 2008.04 (1 year & 3 months)
UK Inter collage , Uttar, Pradesh
Higher Secondary
2006.01 - 2007.04 (1 year & 3 months)
Skills
Team Managementundefined
Availability
See my work availability
Not Available
Available
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Sr. Account Receivable (Hospital Billing)
Cosentus Business Service, CIPL
11.2022 - Current
Associate Hospital Billing
Wipro Limited
2021.12 - 2022.11 (11 months)
Claim Associate Hopital Billing
EMD-s INDIA PRIVATE LIMTED
2021.03 - 2021.12 (9 months)
Senior Analyst HB
R1 RCM global private Ltd
2019.01 - 2020.12 (1 year & 11 months)
Claim Associate ( PB ,HB )
United Health Group, (optum Global Solutions)
2013.01 - 2018.12 (5 years & 11 months)
Kanpur University
Bachelor of Arts from English Literature
2008.07 - 2011.11 (3 years & 4 months)
UK Inter collage
Secondary Examination – Class XII
2007.01 - 2008.04 (1 year & 3 months)
UK Inter collage
Higher Secondary
2006.01 - 2007.04 (1 year & 3 months)
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