Archana Mohan
Medical Claim Specialist
Chennai
Summary
Detail-oriented and experienced Medical Claims Specialist with a strong background in health insurance procedures and medical billing. Seeking to utilize expertise in claims processing, coding, and customer service to ensure accurate and timely reimbursement for healthcare services. Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims.
Overview
3
3
years of professional experience
8
8
years of post-secondary education
Work History
Medical Claims Specialist - Wipro
Client - UnitedHealth Group (UHG)
Chennai
03.2012 - 04.2015
- Processed high volume of medical claims daily, ensuring accuracy and compliance with insurance regulations and company policies
- Reviewed and analysed medical documentation to determine claim validity, coding accuracy, and appropriate reimbursement
- Resolved complex claim issues, including denied or rejected claims, by communicating effectively with healthcare providers and policyholders
- Collaborated with internal teams to identify trends in claims denials and implement strategies for improvement, resulting in 15% decrease in overall denials
- Conducted regular audits of claims to identify potential fraud, waste, and abuse, leading to significant cost savings for company
- Provided exceptional customer service to policyholders, addressing inquiries and concerns regarding claims status, coverage, and billing.
Education
Bachelor of Technology in Computer Science Engineering - Computer Science
Bharath Institute of Higher Education And Research
01.2013 - 04.2017
Diploma in Information Technology - undefined
Sri Balaji Polytechnic
01.2009 - 04.2012
Skills
Excellent attention to detail and accuracy in claims processingundefined
Timeline
Bachelor of Technology in Computer Science Engineering - Computer Science
Bharath Institute of Higher Education And Research
01.2013 - 04.2017
Medical Claims Specialist - Wipro
Client - UnitedHealth Group (UHG)
03.2012 - 04.2015
Diploma in Information Technology - undefined
Sri Balaji Polytechnic
01.2009 - 04.2012
Similar Profiles
Kevin VerSluisKevin VerSluis
Employee Relations Analyst at UnitedHealth Group, UHGEmployee Relations Analyst at UnitedHealth Group, UHG
Stacey ZempelStacey Zempel
Dedicated Client Service Manager at UnitedHealth Group, UHGDedicated Client Service Manager at UnitedHealth Group, UHG
Mel Galvez, MBA, Health Care LeadershipMel Galvez, MBA, Health Care Leadership
Senior Clinical Transformation Consultant at UnitedHealth Group, UHGSenior Clinical Transformation Consultant at UnitedHealth Group, UHG
Hari Krishna NallapareddyHari Krishna Nallapareddy
Lead Engineer at VESTAS WIND TECHNOLOGY INDIA PRIVATE LIMITEDLead Engineer at VESTAS WIND TECHNOLOGY INDIA PRIVATE LIMITED
Herbert Jeffrin MHerbert Jeffrin M
Specialist - Global Funds Control at Bank of New YorkSpecialist - Global Funds Control at Bank of New York