Gaurav Himalyavi

PMS: eCW(e clinical works) I Care Tracker I Cerner

Specialties: Hospital Medicine and Emergency Service I Surgery

Responsibilities

• Responsible for Insurance Denial Management, AR Collections and calling
• Performed root cause analysis when problems arose during the course of processing activities.
• Participated in regular team meetings and provided input on ways to improve existing processes
• Worked on both the forms (CMS 1500 I UB 04)
• Having experience of patient calling.
• Worked as front office executive for provider to schedule patient appointments for them.

PMS: eCW(e clinical works)

Specialty: FQHC(Federally Qualified Health Centers)

Responsibilities

• Performed corrections for patient registration information that includes, but is not limited to, patient demographics and insurance information.
• Responsible for working EDI claim rejections in a timely manner.
• Made outbound phone calls to resolve denial issues.
• Worked on both the claim forms(CMS1500 I UB04).
• Generated and submitted medical claims to insurance companies with a focus on accuracy and timeliness, resulting in a first-pass acceptance rate of 95%.
• Resolved billing discrepancies and denials through thorough research and effective communication with insurance companies and patients.