Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
TECHNICAL ENVIRONMENT & AVAILABILITY
ADDITIONAL INFORMATION
Languages
Timeline
Generic

ANUSHRI GUPTA

Jabalpur,MP

Summary

Results-driven Process Executive with a strong background at Fedora Solutions, specializing in RCM team management and mentoring. Demonstrated success in resolving intricate client issues related to billing and insurance discrepancies, while ensuring compliance with HIPAA and regulatory standards. Instrumental in developing an analytical framework that improved revenue forecasting accuracy and streamlined processes across registration, coding, billing, and customer service departments. Proficient in healthcare data analysis using Excel and Google Sheets, focusing on KPI monitoring and reporting. Effective communicator adept at fostering stakeholder collaboration to enhance operational efficiency.

Overview

4
4
years of professional experience
1
1
Certification

Work History

Process Executive

Fedora Solutions
09.2021 - Current
  • Company Overview: Remote – US healthcare client.
  • Led and mentored a team resolving high-priority client issues related to billing, and insurance discrepancies.
  • Develop an analytical framework that increased the accuracy of revenue forecasting.
  • Developed and proposed RCM functions including, but not limited to, registration, medical records coding, billing, follow-ups, utilization review, compliance, and customer service.
  • Prepare and participate in the preparation of various reports and presentations as needed to communicate programme status, which also includes training sessions on HIPAA compliance, documentation accuracy, and standard procedures.
  • Perform daily operational activities such as ensuring accurate and timely collection of all the data necessary for the processing of authorizations.
  • Organise documentation for medical records and provide information to the insurance company representative during data entry into the system.
  • Answered telephone or online requests and completed interactions quickly to meet productivity goals.
  • Provided training and mentorship to team members, fostering a culture of learning and growth.
  • Manage critical data of clients, which summaries project background, goals, metrics, and milestones.
  • Optimized resource allocation to meet project deadlines, while maintaining high standards of quality.

Education

Bachelor of Engineering (B.E.) - Electronics & Communication

Global Engineering College
Jabalpur, India
07-2018

Skills

  • Team mentoring in revenue cycle management
  • Experience with Medicare, Medicaid, and commercial insurance verification
  • Complex Issue Resolution & Client Escalations
  • HIPAA & Regulatory Compliance
  • Process Optimization & SOP Development
  • KPI Monitoring & Reporting
  • Proficient in data analysis using Excel and Google Sheets
  • Accurate data entry

Accomplishments

  • Certified in AWS Solutions Architect Associate with ExcelR Solutions
  • Three-month internship programme through ExcelR Solutions
  • Fifteen days vocational training from BSNL

Certification

  • HIPAA Compliance Training
  • Advanced Excel for Healthcare Data Management
  • RCM Process & Quality Assurance (In-house Training)

TECHNICAL ENVIRONMENT & AVAILABILITY

  • Equipped with high-speed broadband (5+ MBPS) and mobile data backup
  • 16 GB RAM PC | Dedicated quiet workspace
  • Flexible to work in US business hours

ADDITIONAL INFORMATION

  • Volunteer: Participated in social impact initiatives with humanitarian organizations
  • Represented my school in inter school running competition (1st Rank)

Languages

English
Upper intermediate (B2)
Hindi
Advanced (C1)

Timeline

Process Executive

Fedora Solutions
09.2021 - Current

Bachelor of Engineering (B.E.) - Electronics & Communication

Global Engineering College
ANUSHRI GUPTA