Arihant Jain

• I work for US Healthcare Company in which my responsibility is processing claims, support teams, interaction with client is the main work.
• These claims are hospital (institutional) and professional claims which contain CPT codes, HCPCS codes, Diagnosis codes, POS, Type of bill etc.
• Ensure HIPPA Guidelines were strictly adhered.
• Ensures accuracy and data security of patient information.
• Developed long-lasting relationships with clients to ensure consistent retention and loyalty.
• Maintained up-to-date knowledge on industry trends and regulations, ensuring accurate advice was provided to clients at all times.
• Utilized advanced CRM tools to track client interactions efficiently while maintaining detailed records of their individual goals, preferences, and concerns.
• Maintaining a good quality and accuracy rate of 98% or above.
• Maintaining data in Excel sheet.
• My responsibility is to verify claim that pull correct allowable and is there any authorization requirement and to check for duplicate and process the claim.

Journey till now -

• Skill 1 - Out Network & In Network claims
• Skill 2 - Outpatient & Inpatient claims
• Adjustment
• Correspondence
• Appeals