Jaya Kumar N
Chennai
Summary
Dynamic Quality Auditor with AGS Health, skilled in trend analysis and error prevention. Proven track record in delivering impactful feedback and preparing comprehensive documentation. Expertise in denial management and fostering client relationships, ensuring timely resolutions and enhancing operational efficiency. Committed to driving quality improvements and achieving client satisfaction.
Overview
10
10
years of professional experience
Work History
Quality Auditor
AGS HEALTH
Chennai
09.2022 - Current
- Worked as Quality Auditor with internet tool.
- Finding LQ, AQ and HQ users and giving feedback based on the error marked and to prevent the error in initial stage.
- Daily feedback to LQ users, weekly twice feedback to AQ users and monthly twice for HQ users.
- Prepare weekly feedback document and will connect with users with that feedback documents, and share updated information through weekly call.
- Identifying trends and providing to client to rectify the bulk issues.
- Working in special project named as ETE resolution audit to find out resolutions for the accounts and sharing to OPS Team.
Senior Associate - AR Analyst
Apexon ( Technosoft private ltd )
Chennai
06.2022 - 09.2022
- Managed denial processes for ambulance project by reviewing claims and coordinating with teams to resolve issues effectively.
- Prepared appeals and took appropriate actions to ensure compliance with regulations.
- Audited employee claims weekly, providing actionable feedback to enhance accuracy and compliance.
Senior AR Analyst - Charge, AR
Nsight Solutions Private LTD
Chennai
04.2021 - 06.2022
- Managed aging account categories to ensure timely follow-up.
- Managed denial claims by analyzing and implementing corrective actions.
- Processed charge entries, demographic information, and verified patient eligibility.
- Worked in payment posting to post the ERA, EOB and credit balance.
- Analyzed client mail and initiated appropriate actions to resolve issues.
- Collaborated with specialty teams to streamline processes and enhance operational efficiency.
- Preparing Appeals and sending to the payers via mail & Fax.
- Accurately entering and reviewing medical billing codes for patient services and treatments.
AR Analysis
Acurus solutions private ltd
Chennai
06.2018 - 04.2021
- Managed denial processes and resolved bulk denials to enhance revenue recovery.
- Analyzed client queries and emails to identify trends and resolve issues.
- Working with Health Plan Payor, IPA Payor & Federal Payor etc.
- Requested medical records from clinics and hospitals to ensure comprehensive patient care.
AR Executive
Neltner Business Service Private Limited
Chennai
06.2016 - 06.2018
- Analyzed insurance denials and implemented corrective actions.
- Checked claim status and eligibility by contacting payors and resolved issues promptly.
- Analyzed correspondence files and patient statements to determine necessary follow-up actions.
- Managed denial processes at a healthcare facility.
- Executed tasks according to client instructions.
- Presenting Weekly AR Reports to Client through Zoom Call.
Education
Bachelors of Engineering - CSE
Anna University
Chennai04-2021
HSC -
Govt Boys Her Sec School
Chrompet01-2012
Matriculation -
Govt Boys Her Sec School
Chrompet01-2010
Skills
- Quality auditing
- Denial management
- ETE resolution
- Error prevention
- Trend analysis
- Documentation preparation
- Feedback delivery
Accomplishments
- Secured first prize in Running Race at Sri Ramanujar Engineering College, Vandalur.
- Secured Runner Up in Carrom at Neltner Business Service, Chennai.
Place
Chennai, Tamil Nadu
Personal Information
- Date of Birth: 08/19/94
- Gender: Male
- Nationality: Indian
- Marital Status: Married
- Religion: Hindu
Languages
- Tamil (W&R)
- English (W&R)
Disclaimer
I hereby mention that the above information is true. I believe that my educational skills and abilities match the requirement that your company seeks.
Billing Software Used
- Open Practice Solutions.
- Medical Manager-MM.
- Office ally and Zirmed (Clearing house).
- Capella portal.
- Practice fusion.
- ECW.
- Advanced MD.
- Practice Mate.
- Epic Hyperspace.
Report Work
- RCM report.
- Clinic and Hospital exception.
- Charge report.
Timeline
Quality Auditor
AGS HEALTH
09.2022 - Current
Senior Associate - AR Analyst
Apexon ( Technosoft private ltd )
06.2022 - 09.2022
Senior AR Analyst - Charge, AR
Nsight Solutions Private LTD
04.2021 - 06.2022
AR Analysis
Acurus solutions private ltd
06.2018 - 04.2021
AR Executive
Neltner Business Service Private Limited
06.2016 - 06.2018
Bachelors of Engineering - CSE
Anna University
HSC -
Govt Boys Her Sec School
Matriculation -
Govt Boys Her Sec School