ANUJ RAWAT
Assistant Manager
C 451 Sector 1 Avantika Rohini New Delhi
Summary
Encouraging manager and analytical problem-solver with talents for team building, leading and motivating, as well as excellent customer relations aptitude and relationship-building skills. Proficient in using independent decision-making skills and sound judgment to positively impact company success. Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance.
Overview
10
10
years of professional experience
Work History
Assistant Manager
HOM India Pvt Ltd
07.2019 - Current
- Maintain individual provider files and group information to include up to date information needed to complete the required government and commercial payer credentialing applications.
- Maintain accurate provider profiles on CAQH, PECOS and NPPES etc.
- Complete credentialing and re-credentialing applications for commercial and federal payers (Medicare and Medicaid).
- Ensuring the maintenance of hospital privileges for providers and the efficient handling of appointment and reappointment applications.
- Analyze current credentialing processes to identify areas that can benefit from automation. Evaluate existing workflows and systems to determine automation needs.
- Test automation solutions to ensure they function correctly and meet the required specifications.
Senior Analyst
R1 RCM
06.2018 - 07.2019
- Worked in physician billing which involved verifying and updating insurance details to ensure accurate information for claims processing.
- Worked in credit balance team to identify and analyze credit balances on patient accounts, make necessary adjustments and corrections to patient accounts.
- Process refunds to insurance companies and patients as required, ensuring all refunds comply with regulatory guidelines and organizational policies.
- Worked as Payment Posting Analyst to apply insurance payments and adjustment based on explanation of benefits.
Associate Team Member
Guardian India Operations Pvt. Ltd.
05.2017 - 06.2018
- Manage the initial credentialing and recredentialing process for dental providers and ensure timely submission, processing of applications.
- Verify provider qualifications, including education, licensure, board certification and work history.
- Conduct primary source verification of credentials with educational institution, licensing boards etc.
- Conduct regular audits of credentialing files to ensure accuracy and completeness, implement corrective actions for any discrepancies or deficiencies identified.
Junior Engineer
HCL Technologies BPO Services
11.2014 - 11.2015
Education
B.B.A/ B.M.S - Management -
Guru Gobind Singh Indraprastha University (GGSIU)
12th - undefined
10th - undefined
Skills
Employee Performance Evaluations
Workload Management
Quality Assurance
Mentoring and Training
Automated Software Testing
Remote Team Management
Meeting Facilitation
Succession Planning
Performance Appraisal
Team Development
Team Building
Timeline
Assistant Manager
HOM India Pvt Ltd
07.2019 - Current
Senior Analyst
R1 RCM
06.2018 - 07.2019
Associate Team Member
Guardian India Operations Pvt. Ltd.
05.2017 - 06.2018
Junior Engineer
HCL Technologies BPO Services
11.2014 - 11.2015
B.B.A/ B.M.S - Management -
Guru Gobind Singh Indraprastha University (GGSIU)