Jedidiah Gudimetla

• Verified, coded and added modifiers to diagnoses.
• Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
• Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
• Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
• Reviewed patient charts to better understand health histories, diagnoses and treatments.
• Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
• Resourcefully used various coding books, procedure manuals and on-line encoders.

• Worked on Denials and resolving the issue to clear the claim as per the Payer/Provider guidelines.
• Strong Knowledge on Denials and has been pro-actively working to clear the daily targets and TAT
• Working on Reports like – ageing report and inventory assignment, Daily Production and Quality reports.
• Strong Knowledge on Billing Rejections and has been playing key role in bringing down the inventory to current date.
• Refined existing processes to optimize accounts receivable and collection efforts.
• Developed and maintained strong relationships to deliver exceptional customer service support.
• Reconciled accounts receivable ledger to account for and properly post payments.

TieCare and Corporate Clients:

• Worked as Senior Coordinator in Enrollment & Client Services Department.
• Group Enrollments: Worked in TieCare and Corporate group enrollments (Large groups)
• TieCare: Primary department in group enrollment business that deals with International schools across globe.
• Handling the group as Business coordinator and deals with all the membership setup, changes and terminations of primary members.
• Members are primarily the expatriate employees in a School/Group.
• Setup the Schedule of Benefits and creating a Group Master Policy.
• Providing the ID Cards and Life/Disability Certificates.
• Invoicing the group and payments follow-up, Posting.
• Providing the Soft and Hard copies of the enrollment Kits.

Catlin Business:

• This is the type of Business that provides accident and Emergency coverage to students in a school who met with accident.
• Blanket Policy: Coverage provided for 365days form the day the student met with accident and can avail services.
• Voluntary Policy: Students purchase the policy per school year in advance and can avail emergency accidental coverage

• Worked as a Sr. Process Associate for Anthem Client- WellPoint(US Health Care)
• Processing the Enrollment forms for WellPoint Health Insurance(US)
• Enrolling the Subscriber`s data, Maintenance and Terminating the contracts in the system, so that subscribers get correct payments for the services rendered and completing the tasks within TAT.
• Processing the subscriber Enrollments, Maintenance and Terminations for Large and Small Groups of Well point Customers.
• Handling the Missing Info project individually and no single escalation in that queue since last three years.
• Doing internal audit in MI project since last 3 years.
• To maintain the daily production and quality reports of the associates.
• Sending the Mentor updates to the associates and explain the new topics.
• Mentoring and monitoring the new associates in MI Process and Enrollment Process.
• Supporting the team in IMO1 Process.
• Cross trained in all the four processes in Facets Enrollment.