To join a company that offers me a stable and positive atmosphere and inspires me to enhance and therefore to innovate the work culture for the betterment of all parties concerned.
Carrier Summary
*7 years of relevant experience in medical billing RCM domain.
*Worked Worker's compensation & MVA claims for 1.5 years.
*Worked Hospital Billing (UB-04) for 3 years .
*Worked physician Billing (CMS1500) for 2.5 years.
*Heading AR team with 17 FTEs.
*Rich knowledge and passionate in achieving service level agreement.
*Excellent in analytical ability, interpersonal , organizational , communication skills and execution of plans.
*Highly proactive in terms of process as per the domain demands and standards.
Senior Account Receivable specialist
*Worked on back dated & supervisor WQ accounts.
*Allocation of tasks to AR analyst and Callers based on the volume received.
*Acting as a back up associate team leader.
*Monitoring the time frame for the work completion based on the process TAT.
*Conducting training for the AR callers based on the process protocol.
*Responsible for clarifying queries rise by team members.
*Responsible for assigning daily tasks to the agents and providing the completion report to team leader by day end.
*Motivate team to achieve peak productivity and performance.
*Inventory analysis and trend reports driven towards resolution/cash collection.
*Developing in-depth knowledge base among the team members relating to domain and process.
*Identifying gaps in the process knowledge of the team and take appropriate actions to fill the same.
*Supporting operations manager in preparation of deck for client reviews.
*Participating in client reviews and meetings.
*Mentoring AR callers and AR analyst trainees at their initial stage and responsible for their productivity and quality till the ramp-up period .
*Making sure the outstanding days in AR are under control and if it is beyond the TAT, then responsible to provide a proper POA and monitoring the implemented process.
Senior Quality Analyst
*Responsible for Account receivables team 45+ on their Quality .
*Monitoring day to day quality & reporting the progress of the team and to the Management.
*Reporting to the project manager with regards to the regular queries.
*Monitoring the Process Associate Quality on daily/ weekly basis.
*Sending reports (Daily report,weekly report,Monthly report & CAP report) on a daily,weekly and monthly basis to Client.
*Motivating the team in increasing the qualitative performance.
*Supporting the Operations Manager in preparation of deck for client reviews.
*Identify gaps in the process knowledge of the team and take appropriate actions to fill the same.
*provide periodic inputs to the team based on the client updates.
*Inventory analysis and trend reports driven towards resolution/cash collection.
*Developing in-depth knowledge base among the team members relating to domain and process.
*Identifying gaps in the process knowledge of the team and take appropriate actions to fill the same.
*Participating in client reviews and meetings.
*Initiate telephone calls to the insurance companies requesting status / denials of claims in-queue .
*Responsible for prompt account follow-up, EOB reviews for payment appropriateness or denials.
*Resolved account non-payment issues resulting from invalid codes, missing documentation and /or other miscellaneous reasons for non-payment of claim (including appeal).
*Verify insurance coverage.
*Submit medical claims/Appeals to insurance companies as electronic and paper.
*Effective Time Management
*Ability to work in a team
*Leadership
*Microsoft Office
*SQL & PowerBI Knowledge
*Trained nearly 50+ users from 2020 and their are 11 user still working with our organization with good production and quality.
*Provided a resolution for the WC & MVA claims were the client has no idea and received aappreciation mail for that .
*Improved Team quality from 60 % to 90 % with in a period of 6 months to met the client SLA