Next Generation
Kajal Singh Parihar
Account Receivable
Mumbai
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
9
9
years of professional experience
1
1
Language
6
6
years of post-secondary education
Work History
Revenue Cycle Officer (Subject Matter Expert)
Inventurus Knowledge Solutions Private Limited
2023.02 - Current
- Assist with training for all new AR staff, serving as SME for accounts receivable questions from staff
- Handfull knowledge of RCM scopes - Payment, Denials, Appeals and end to end billing process
- Reviews medical records to determine if services identified were medically necessary in accordance with state policies and federal regulations
- To prioritise pending claims for calling from ageing basket
- To make physical call by following international norms and applicable rules for confidentiality and HIPAA compliance
- Meeting daily/weekly and monthly targets set for individual
- To coach team members. Identifies development areas and helps individuals and team to improve their performance and enhance their potential
- Ability to take supervisory calls
- Conducted regular audits of billing activities to identify areas for improvement and implement corrective action plans accordingly.
- Reduced accounts receivable days outstanding with diligent follow-ups and effective communication with payers.
- Collaborated with clinical teams to ensure proper documentation for accurate billing purposes, minimizing claim rejections.
Senior AR Associate
GeBBS Healthcare Solutions Pvt Ltd
2022.04 - 2023.01
- Responsible for calling insurance companies (in US) on behalf of doctors/physicians and following up on outstanding Account Receivable
- Make Pre-Call Analysis on claims before making calls to insurance companies
- Call insurance companies directly and convince them for payment of their outstanding claims
- Prioritise unpaid claims for calling according to length of time it has been outstanding
- Check relevance of insurance information offered by patient
- Evaluate unpaid insurance claims
- Transfer outstanding balance to patient if he/she doesn't have adequate insurance coverage
- If claim has already been paid, ask insurance company for explanation of benefit (EOB)
- Make corrections to claims based on inputs from insurance company
- Coordinate with US based client on daily basis on WFT's assigned.
Analyst
R1 RCM Global Services Pvt Ltd
2019.12 - 2021.09
- Responsible for calling insurance companies (in US) on behalf of doctors/physicians and following up on outstanding Account Receivable
- Make Pre-Call Analysis on claims before making calls to insurance companies
- Call insurance companies directly and convince them for payment of their outstanding claims
- Worked with Payment variance team also where was leading US site for Pensacola and Tulsa
- Identify reason for variance and validate payment discrepancies as per contract, 837 charges and EOB (Explanation of benefit)
- Understanding source of variance is first step to resolve and obtain full reimbursement
- Variances include underpayments, over-payments, and denials
- Identify and isolate payment variance trends and discrepancies, escalate as appropriate to onshore team
- Prepare weekly reports for under payment/Over payment reviews
- Team Management
Data Loading Associate
Optum Global Solutions (India) Private Limited
2016.09 - 2019.12
- Responsible for updated services and rates in claim setup and creating fee schedule for In-network and Out of network providers
- Core responsibilities are verifying contract details, contact held between UHG and various hospital service providers for claims setup
- Loading of contract rates into system and their front-end application for claims reimbursement and medical billing
- Direct coordination with onshore team (Network Management and Tech Team) for each contract
- Each load must be 100% audit with 100% quality, in order to deliver high standard of services and to ensure no financial impact for clients and customers
Executive – Data Management
Get it Grocery Pvt. Ltd
2015.07 - 2016.08
- Cleaning of Raw Data using Excel functions and formulas
- Calculating Dealer Price and Selling Price using floor and round function
- Checking of inserted and updated data using V-lookup and Index- match
- Compiling the typed data and uploading in database
- Prepare, compile and sort documents for data entry
- Check source data for accuracy
- Verify data and correct data where necessary
- Obtain further information for incomplete documents
- Update data and put remarks on unnecessary data
- Combine and rearrange data from source documents where required
- Enter data from source into prescribed database
- Check completed work for accuracy
- Store completed files in designated locations
- Maintain log books or records of activities and tasks
- Respond to requests for information and access relevant files
- Print information when required
- Comply with data integrity and security policies
Education
B. Com - Finance
Delhi University
New Delhi 2011.06 - 2015.07
H.S.C -
Central Board of Secondary Education
New Delhi 2010.04 - 2011.04
S.S.C -
Central Board of Secondary Education
New Delhi 2008.01 - 2009.04
Skills
Proficient in MS office
undefinedSoftware
AdvancedMD
Additional Information
I am familiar with Waystar, Phreesia, and other provider portals.
Timeline
Revenue Cycle Officer (Subject Matter Expert)
Inventurus Knowledge Solutions Private Limited
2023.02 - Current
Senior AR Associate
GeBBS Healthcare Solutions Pvt Ltd
2022.04 - 2023.01
Analyst
R1 RCM Global Services Pvt Ltd
2019.12 - 2021.09
Data Loading Associate
Optum Global Solutions (India) Private Limited
2016.09 - 2019.12
Executive – Data Management
Get it Grocery Pvt. Ltd
2015.07 - 2016.08
B. Com - Finance
Delhi University
2011.06 - 2015.07
H.S.C -
Central Board of Secondary Education
2010.04 - 2011.04
S.S.C -
Central Board of Secondary Education
2008.01 - 2009.04
Accomplishments
- Supervised team of 12 staff members.
- Used Microsoft Excel to develop inventory tracking spreadsheets.
Personal Information
- Date of Birth: 08/02/92
- Nationality: Indian
- Marital Status: Married
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