As a seasoned claims processing professional, I bring a wealth of experience in guiding, training, and directing team members to achieve excellence in our field. My expertise lies in handling high-ageing accounts and navigating client escalation cases with ease, ensuring complex queries are resolved and timely solutions are delivered. I take pride in my role in creating a collaborative work environment, where I actively assist and support my colleagues to keep them updated on the latest process and product knowledge. My proficiency extends to generating detailed daily quality reports, actively participating in quality meetings, and providing constructive feedback, all aimed at boosting team performance and efficiency. Additionally, I possess strategic insight into enhancing company profitability and growth, both organically and inorganically, by advising on optimal capital structure leverage.
Responsibilities:
• As a Quality Analyst, responsibilities include conducting audit reports to assess adherence to quality standards, providing feedback to team members based on audit findings, and facilitating quality meetings to discuss improvement strategies. Additionally, they oversee Quality Assurance Testing (QAT), ensure client calibration for consistency in evaluations, handle client calls related to quality concerns, and lead team huddles to address performance issues and share best practices for quality improvement.
• Analyze and evaluate the quality of claims processing operations to ensure adherence to company standards and regulatory requirements.
• Provide guidance, training, and feedback to team members to enhance performance and ensure consistent quality output.
• Handle high-priority accounts and address client escalations effectively to maintain customer satisfaction.
• Prepare daily quality reports and participate in quality meetings to discuss improvement strategies and best practices
Responsibilities:
• Managed accounts receivable processes for medical billing operations, including claim submission, payment posting, and denial management.
• Identified and resolved billing discrepancies and coding errors to expedite claim reimbursement and minimize revenue loss
• Collaborated with cross-functional teams to implement process improvements and enhance overall efficiency.
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PROJECT:
A STUDY ON STRESS MANAGEMENT ON THE EMPLOYEES WORKING IN GEBBS HEALTHCARE SOLUTIONS PVT LTD
• Ability to work efficiently under pressure and face challenge’s.
• Good interpersonal relationship
• Good listener & learner