K. Sampath Kumar
Hyderabad
Summary
Accomplished Senior Associate with a proven track record at Pro chant Ind Pvt Ltd., enhancing billing accuracy and efficiency. Skilled in HP Billing and recognized for exceptional team collaboration. Developed SOPs and improved quality control, significantly contributing to process optimization. Expert in analyzing and resolving billing discrepancies, ensuring compliance and customer satisfaction.
Overview
7
7
years of professional experience
Work History
Senior Associate
Pro chant Ind Pvt Ltd.
Remote
02.2022 - 09.2024
- Processed invoice payments, recorded information in the account database, and contacted insurance providers to verify insurance information and obtain billing authorization. Prepared documents for filing appeals with insurance companies when necessary..
- Analyzed patient accounts to determine appropriate payment plans, and assessed billing statements for correct diagnostic codes, and identified problems with coding.
- Verified the accuracy of all charges billed for services rendered by providers. Reviewed and processed patient invoices to ensure accuracy.
- Given opportunity to work as an off-paper Internal Quality Analyst, I prepared checklists, SOPs, and process SOPs for the team, and I prepared hierarchical SOPs for easy use by the users who are below the benchmark. benchmark.
- Allocating inventory for self, and cross-auditing for quality betterment.
- Data monitoring and reporting to management on a weekly and monthly basis. And used to conduct root cause analysis to investigate the source of problems in the production process.
Senior Claims Representative
United Health Group
Hyderabad
11.2020 - 02.2022
- Delivered quality customer service to assigned, insured and claimants throughout entire claims lifecycle to promote service times.
- Precisely calculated refunds, premiums, and adjustments.
- Provided guidance and training to junior associates on effective claim processing techniques.
- Provided guidance to new employees regarding onboarding processes and policies.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
Analyst
R1 RCM
08.2019 - 08.2020
- Contacted insurance companies to check the status of claim payments, and checking with customers' delinquent accounts to solicit payment.
- I wrote appeal letters to insurance companies for the denial of claims, and I processed payments from customers in a timely manner according to established procedures.
- Researched and resolved discrepancies between patient accounts and third-party payers.
- Recognized by management for providing exceptional customer service.
- Provided support and guidance to colleagues to maintain a collaborative work environment.
Claim Representative
United Health Group
04.2017 - 07.2019
- Reviewed and processed incoming claims to determine applicable coverage, appropriate levels of coverage, and assist with approval or denial decisions.
- As part of the work, I determined eligibility for coverage based on policy terms and provided explanations of findings to claimants.
- Utilized claims processing software to manage and track claim progress.
- Identified discrepancies in claim information and requested additional information from claimants.
- Consistently maintained the accuracy and production as per requirements.
- Communicated effectively with the team on all the updates shared by my supervisor.
Education
Degree -
PragathiMahavidyala
01.2016
Intermediate (10+2) -
Board of Intermediate Hyderabad
01.2013
S.S.C -
State Board of Secondary Education
01.2011
Skills
- HP Billing
- Laserfiche
- Citrix
- Waystar
- CPR
- Care link
- Care Trend
Accomplishments
- Achieved Excellence, Star Award in the first month of UHG and Prochant.
- Received Spot Awards in R1 RCM, Multiple Times.
- Achieved milestone award for my team in Quality Bench Mark twice in a year in Pro chant.
- Received Appreciation Mail from Client’s end as 0 Error Escalation for my team in 2023.
Languages
- English
- Hindi
- Telugu
Personal Information
- Father's Name: K. Krishna Chary
- Date of Birth: 08/29/95
- Marital Status: Married
Timeline
Senior Associate
Pro chant Ind Pvt Ltd.
02.2022 - 09.2024
Senior Claims Representative
United Health Group
11.2020 - 02.2022
Analyst
R1 RCM
08.2019 - 08.2020
Claim Representative
United Health Group
04.2017 - 07.2019
Degree -
PragathiMahavidyala
Intermediate (10+2) -
Board of Intermediate Hyderabad
S.S.C -
State Board of Secondary Education
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