Channakeshava C M

• Handling the escalated issues from the clients related to claim processing.

• Consolidated production report on daily basis and sharing the same report within the team members

• Conducting error share meetings and addressing resolutions within the team.

• Preparing questions of rebuttals version for errors occurred.

• Framing question for monthly assignments.

• Taking care of all client escalations communication by mail.

• Assist clients for updating memo and documents.

• Mentoring new joiners and helping them to gaining knowledge.

• Maintaining monthly reports related to claims and sending same to the concern team within TAT

• Helping other executive for determination of COB, BOB, Medicare and medical policy claims.

• Responsible for attending client calls related to new memo updates and interacting with them via mails or phone.

• Maintain an updated memo and address to my team while sending MOM to the management.

• Claim adjudication
• Procedure code and diagenesis validation
• patient authorization validation
• Member benefit validation
• member profile validation

• Provider audit
• Discussing defect in daily handle with the team
• Processing claims for the payment, based on inventory
• Maintaining weekly / monthly reports related to claims and sending same to the respective team within TAT
• Responsible for attending client calls related to new memo updates and interacting with them via mails or phone .