DEEPAK S M

As a Process Executive(Healthcare) having extensive knowledge of commercial, Medicaid, Medicare claims and process guidelines; sound knowledge of medical coding billing software; and a strong understanding of different providers' payment methodologies; and relevant work experience.

Having knowledge of complex Federal laws, State Statutes, Administrative Rules, and policy manuals.

Work Experience with, CATS, RUMBA, ASD(PegaREACH), HRP, HEALTHEDGE, MHK, MedHOK, applications.

Having knowledge of Med Compass, ECRP, Clinical vs non clinical Grid, NPPES, Smart Front, CCR Prep.

Responsible for accurate and timely adjudication of claims. Verify patients accounts, eligibility benefits and authorization. Follow up with the provider if necessary.

Expertise in all facts of investigation, negotiation and reimbursement of healthcare claims An excellent communicator credited with building positive customer and provider relationships utilizing a high level of professionalism when negotiating claims to facilitate problem-solving and minimize conflict. Collaborative communicators focused on building top-performing teams and promoting cooperation across business lines to drive comprehensive business approaches. Areas of Expertise include:Caseload Management .

Claims Investigations ✓Client/Provider Relations, State/Federal Regulations, Medical Coding & Pricing Staff Training & Leadership,Negotiation, Regulatory Compliance Records management, Problem Resolution, Presentation skills.

Manage large diverse caseload of government and private sector claims specializing in procuring a wide range of supplies and services to support Medicare and Medicaid programs, including research studies and demonstrations. consultant services, utilization of health services, and provider fraud and abuse Deliver excellent customer and provider service by building strong positive relationships and assisting with the
resolutions of disputes.