Summary
Overview
Work History
Education
Skills
Languages
Disclaimer
Timeline
Generic

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
JANANI