DINESH KUMAR
Chennai
Summary
Dedicated Claim Adjudicator with two years 6months of experience working in Neltner business PVT LTD.Solving claim issues by Interaction with clients through the mail, Letters to other departments, and taking care of all the activities related to claims.
Overview
2
2
years of professional experience
Work History
Claim processor
NELTNER BUSINESS SERVICES PVT LTD
08.2024 - Current
- Mentor, EHUB, CGX, Medhok (MHK), Customer relationship management (CRM).
- Easily adaptable to changes, Good in Interpersonal relationship, Goal oriented and Hardworking, Self Motivated, Creative thinking.
- Analyzing medical records of the member and the provider information.
- Taking necessary actions for the denials.
- Resolving Authorization and Referral denials.
- Checking for the payment status (either full amount, half amount or deny the amount) and sending the letters to the respective teams.
- Follow up and receive incorrect payments in a timely manner.
- Sending a letter to the provider in case the member is not responsible for payment.
- Responsible for reviewing work for quality and accuracy on a regular basis.
Education
B.com - Accounts and finance
Asan Memorial college of arts and science
Guru nanak matriculation higher secondary school -
Guru nanak matriculation higher secondary school
Skills
- Nxtgen gps
- Citrix Application
- Claim Administrative
- Medhok (MHK)
- Claim processing
- Claims adjudication
Hobbies and Interests
- Photography
- Football
Personal Information
- Date of Birth: 05/25/03
- Nationality: Indian
- Marital Status: Single
Languages
- English Tamil
Timeline
Claim processor
NELTNER BUSINESS SERVICES PVT LTD
08.2024 - Current
B.com - Accounts and finance
Asan Memorial college of arts and science
Guru nanak matriculation higher secondary school -
Guru nanak matriculation higher secondary school