Summary
Overview
Work History
Education
Skills
Timeline
Generic

Avhik Bhadra

Kolkata

Summary

Approachable Medical Claims Processor proudly offering over 3 years' experience in handling multiple administrative responsibilities in fast-paced office environments. Hardworking professional interacting with providers to discuss claim status or denials. Attentive to details and highly collaborative. Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Organized and motivated employee eager to apply time management and organizational skills in various environments. Seeking entry-level opportunities to expand skills while facilitating company growth.

Overview

3
3
years of professional experience

Work History

Medical Claims Processor

WIPRO
Kolkata
11.2020 - 05.2024
  • Reviewed medical claims for accuracy and completeness, verifying patient eligibility and coding.
  • Ensured compliance with insurance company policies and procedures related to the processing of claims.
  • Investigated discrepancies in medical billing information such as incorrect codes or amounts due.
  • Processed a high volume of claims on a daily basis using established time frames.
  • Researched claim denials and appeals to determine appropriate resolution.
  • Responded promptly to customer inquiries regarding claim status or other issues.
  • Maintained up-to-date knowledge of health care industry trends and changes in regulations affecting medical billing processes.
  • Calculated payments due based on allowed charges compared to billed charges according to contract terms with payers, insurers, third parties.
  • Performed Quality Assurance checks on processed claims ensuring all edits were resolved prior to submitting them for adjudication and payment.
  • Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
  • Accurately processed large volume of medical claims every shift.

Education

Bachelor of Commerce - Accounting

University of Calcutta
Kolkata
06-2020

Higher Secondary (C.B.S.E) - Computer Science

Sudhir Memorial Institute
Kolkata
03-2015

Matriculation (I.C.S.E) - Computer Science And Programming

The Central Modern School
Kolkata
03-2013

Skills

  • Insurance claims management
  • HIPAA
  • Proficiency in [Cirrus]
  • Claim validity determination
  • Medical terminology knowledge
  • Eligibility Determination

Timeline

Medical Claims Processor

WIPRO
11.2020 - 05.2024

Bachelor of Commerce - Accounting

University of Calcutta

Higher Secondary (C.B.S.E) - Computer Science

Sudhir Memorial Institute

Matriculation (I.C.S.E) - Computer Science And Programming

The Central Modern School
Avhik Bhadra