Hi, I’m
GANESH KUMAR Krishnamoorthy
Coimbatore
Summary
Experienced healthcare analyst with a broad understanding of healthcare data, including claims, clinical data, quality metrics, and health outcomes. Capable of analyzing complex problems and designing effective recommendations such as workflows, processes, and procedures. Detail-oriented and quality-focused professional billing specialist with a successful track record in handling complicated assignments. Highly experienced in reconciling insurance and patient payments and resolving account disputes using various practice management software applications. Dedicated to maintaining strict patient confidentiality. Proven ability to achieve tangible results and foster cross-team collaboration. Adaptable billing specialist with extensive experience delivering first-class results. Consistently meets job demands and deadlines through a diligent work ethic and dedication to quality. Detail-oriented individual with exceptional communication and project management skills. Recognized for taking a proactive approach to identifying and addressing issues, with a focus on optimizing processes and supporting team objectives.
Overview
11
years of professional experience
Work History
Northern & Quantum Prosthetics and Orthotics
Practitioner Department Assistant
12.2020 - Current
Job overview
- Verifying patient eligibility and benefits
- Determine whether authorization is required and initiating one if needed
- Filing claims to respective Insurance and following up on claims.
- Posting payments and work on denied claims, providing required documents to process the claim, and makes sure that every claim gets paid.
- Responsible for the payments from Insurance to the provider, providing end to end support to the providers
- Met schedule using excellent planning and coordination skills.
US, Sharp Info Solutions
Healthcare Medical analyst & AR caller
03.2019 - 11.2020
Job overview
- Analyzing claims and working on denied claims
- Making sure the denied claims are paid by the Insurance by calling them and providing them with the required documents to process the claim
- Main aim is to get payment from insurance for all the claims
- Making calls to insurance company to check on Insurance verification of the member
- On the whole, responsible for the payment from Insurance to the provider, handling End to End support for the provider
- Provide accurate service information to customer, research available documentation including authorization, nursing notes, medical documentation on client's systems, interpret explanation of benefits received etc., prior to making the call
- Achieved service time and quality targets.
McKinsey & company
Business presentation specialist
05.2017 - 09.2018
Job overview
- Supports McKinsey consultants in creating the PowerPoint presentation with professional standards
- Giving business oriented layouts and designs in accordance with the company's needs
- Sound knowledge on the topics on which the presentation is about to deal with
- Supported almost all MNC's and US Government projects and much more
- Extensive knowledge of all features in PowerPoint software
- Excellent interpersonal and oral communication skills
- Good ability to collaborate with managers in designing effective presentations.
US, Dell international Pvt.Ltd
Healthcare Medical Biller
02.2014 - 03.2017
Job overview
- Prepare and submit billing data and medical claims to insurance companies
- Prepare bills and invoices, and document amounts due for medical procedures and services
- Collect and review referrals and pre-authorizations.Monitor and record late payments
- Follow-up on missed payments and resolve financial discrepancies
- Examine patient bills for accuracy and request any missing information.
Education
Bharathiar University
Bachelors from Business Management
2013
Laurel Matriculation higher secondary school
Higher Secondary Examination
2008
Laurel Matriculation higher secondary school
2006
Skills
- Personality Traits:
- Good communication Skills
- Excellent in situation handling
- Problem solving capability
- Always proved a key employee for the company
- Health department regulations
- HIPAA compliance
- Healthcare analytics
- Medical billing
- Healthcare policy
- Patient data management
- Clinical documentation
- Healthcare billing
- Excellent communication
- Reliability
- Multitasking Abilities
- Critical thinking
- Organizational skills
- Active listening
- Team collaboration
- Effective communication
- Adaptability and flexibility
- Verbal and written communication
- Decision-making
- Detail-oriented
- Claims processing
- Insurance verification
- Analytical thinking
- Patient data confidentiality
- Insurance billing
- Patient information verification
- Time management abilities
- Adaptability
- Billing procedures
- Patient health information Access
- Patient medical records maintenance
- Medical billing code accuracy
Timeline
Practitioner Department Assistant
Northern & Quantum Prosthetics and Orthotics
12.2020 - Current
Healthcare Medical analyst & AR caller
US, Sharp Info Solutions
03.2019 - 11.2020
Business presentation specialist
McKinsey & company
05.2017 - 09.2018
Healthcare Medical Biller
US, Dell international Pvt.Ltd
02.2014 - 03.2017
Laurel Matriculation higher secondary school
Higher Secondary Examination
Laurel Matriculation higher secondary school
Bharathiar University
Bachelors from Business Management
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