Open To Work
Harish M
Chennai
Summary
Over 1 years' healthcare BPO service and Healthcare & Insurance experience in operations. Excellent multi-tasking abilities; quick and effective problem solver. Highly adaptable; thrive on challenges and excel in new environments. Able to produce positive results independently; extremely self-motivated. Dedicated and dependable, believing internal principles to dictate performance.
Overview
1
1
year of professional experience
5
5
years of post-secondary education
Work History
Claims Processor
Neltner Business Services Pvt
Chennai
11.2024 - 12.2025
- I handled healthcare project GCIIP
- Review and analysis Electronic claims to a new system (Edifecs EDI), Paper Claims, Timeliness & Payment
- Processed COB, Medicaid, Medicare, and outpatient claims for both professional and institutional providers.
- Managed provider data by updating information and verifying documents.
- Reviewed EOB and payment details to identify underpayments and correct adjustment errors, ensuring accurate claim settlements.
- Prepared and submitted dispute requests with supporting documentation such as claim forms, EOB, and provider contracts.
- Coordinated with payer portals and internal teams to track dispute statuses and facilitate timely claim reprocessing.
- Claims that exceed a certain cost threshold (e.g., over $10,000) are routed for specialized review.
Education
Bachelor of Arts - B.com General
DRBCCC HINDU COLLEGE
Pattabiram 06.2021 - 01.2024
HSC -
Dasar's Higher Secondary School
Thiruninravur 06.2019 - 01.2021
SSLC -
Dasar's Higher Secondary School
Thiruninravur 06.2018 - 01.2019
Skills
- Claims processing
- Advanced Excel
- MS Excel
- MS Access
- MS Word
- Outlook
- MS PowerPoint
- Internet and computer Application
- IIRP
Languages
English
Upper Intermediate
B2
Tamil
Proficient
C2
Work Preference
Job Search Status
Open to workWork Type
Full TimeSalary Range
₹100000/yr - ₹200000/yrTimeline
Claims Processor
Neltner Business Services Pvt
11.2024 - 12.2025
Bachelor of Arts - B.com General
DRBCCC HINDU COLLEGE
06.2021 - 01.2024
HSC -
Dasar's Higher Secondary School
06.2019 - 01.2021
SSLC -
Dasar's Higher Secondary School
06.2018 - 01.2019