JANANI
Contact Info :
Summary
Results-driven Quality Control Analyst with 5+ years of experience in AR Calling, AR Analysis, Eligibility Verification, and project management. Expertise in quality auditing, data integrity, and print/mail production optimization. Track record of enhancing operational efficiency and implementing effective quality control measures. Skilled in leading cross-functional teams and managing complex projects to achieve superior results.
Overview
7
7
years of professional experience
Work History
Quality Control Analyst
Omega Healthcare
11.2023 - Current
- Share daily, weekly, and monthly Quality Score with the quality lead and Operations team.
- Authored in-depth Root Cause Analysis (RCA) reports and instituted Corrective and Preventive Actions (CAPA), ensuring rigorous compliance with Quality SLA and driving continuous operational refinement.
- Led targeted training sessions for new employees, delivered process clarity to team members, and presided over high-impact review meetings, promoting a culture of excellence, accountability, and continuous optimization.
Non - Designated Quality Control Analyst
Annexmed Pvt Ltd
07.2022 - 01.2023
- Reviewed billing processes and claims to find and fix errors, improving accuracy and compliance.
- Worked with the team to resolve claim denials by identifying the causes and helping prevent future issues.
- Gave feedback on coding and billing practices to reduce mistakes and ensure smoother claim submissions.
- Monitored billing workflows to ensure claims were submitted correctly and on time.
- Helped prepare reports to track billing performance and spot trends in claim denials.
- Assisted in training team members by explaining billing and coding procedures in simple terms.
SENIOR AR CALLER
Annexmed Pvt Ltd
03.2020 - 07.2022
- Understand the top payers to which the practice sends claim and initiate contact with the payers
- Timely follow-up with the Payer to track Provider Credentialing and Enrollment application status
- Collect all the data and documents required for filing credentialing applications from the physicians
- Prepare call notes, initiate, or execute the corrective measures by sending necessary documents to Payers
- Record the actions and post the notes on the client's revenue cycle software
- Use appropriate client specific call note standards for documentation
- Achieved performance goals on consistent basis
- Facilitated past due invoice payments by sending bill reminders and contacting insurances
- Notified team members of delinquent accounts to assist in reaching insurance and denials status
- Perform all other duties, as assigned.
AR CALLER
Global Healthcare
08.2019 - 03.2020
- Analyzed aging reports to identify trends and patterns causing missed collections
- Streamlined daily reporting information entry for efficient record keeping purposes
- Implemented new accounting processes to decrease spending and workflow downtime
- Managed complex problem-solving for upper management to complete projects on-time
- Liaised with other departments to investigate and resolve order or claim-related issues
- Verified discrepancies to resolve claim issues
- Researched billing errors and discrepancies to initiate corrective action
- Prepared and submitted Appeal documents to initiate insurance proceedings.
AR CALLER
Omega Healthcare
12.2017 - 04.2019
- Review the claim allocated and check status by calling the payer or through IVR /Web Portal
- Ask a series of relevant questions depending on the issue with the claim and record the responses
- Verified insurance eligibility for patients via insurance portals and telephone
- Maintained high volume of calls and met demands of busy and productive group
- Worked in call center environment handling manual and automatically dialed outbound calls
- Used scripted conversation prompts to convey current account information and obtain payments.
Education
BCA (Bachelor of Computer Application) -
University of Madras
01.2016
Diploma in Computer Engineering (DCE) - undefined
Meenakshi Krishnan Polytechnic College
01.2010
S.S.L.C - undefined
St. Theresa Girls Higher Secondary School
01.2007
Skills
- ICD-10
- CPT Coding
- Anatomy, Physiology and Terminology
- Medical terminology
- Codes reviewing
- Medical Billing / Accounts Receivable
- Accurate payment posting
- Multitasking Abilities
- Aging reports analysis
- Problem-Solving
- MS Office
- Written Communication
Languages
Tamil
English
Disclaimer
I hereby declare that above given particulars are true to my knowledge and if am given a chance to serve in your concern, I will fulfill all duties to the entire satisfaction of my superiors.
Timeline
Quality Control Analyst
Omega Healthcare
11.2023 - Current
Non - Designated Quality Control Analyst
Annexmed Pvt Ltd
07.2022 - 01.2023
SENIOR AR CALLER
Annexmed Pvt Ltd
03.2020 - 07.2022
AR CALLER
Global Healthcare
08.2019 - 03.2020
AR CALLER
Omega Healthcare
12.2017 - 04.2019
BCA (Bachelor of Computer Application) -
University of Madras
Diploma in Computer Engineering (DCE) - undefined
Meenakshi Krishnan Polytechnic College
S.S.L.C - undefined
St. Theresa Girls Higher Secondary School
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