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
02.2023 - 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
04.2022 - 01.2023
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
12.2019 - 09.2021
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
09.2016 - 12.2019
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
07.2015 - 08.2016
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
06.2011 - 07.2015
H.S.C -
Central Board of Secondary Education
New Delhi
04.2010 - 04.2011
S.S.C -
Central Board of Secondary Education
New Delhi
01.2008 - 04.2009
Skills
Proficient in MS office
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Software
Next Generation
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
02.2023 - Current
Senior AR Associate
GeBBS Healthcare Solutions Pvt Ltd
04.2022 - 01.2023
Analyst
R1 RCM Global Services Pvt Ltd
12.2019 - 09.2021
Data Loading Associate
Optum Global Solutions (India) Private Limited
09.2016 - 12.2019
Executive – Data Management
Get it Grocery Pvt. Ltd
07.2015 - 08.2016
B. Com - Finance
Delhi University
06.2011 - 07.2015
H.S.C -
Central Board of Secondary Education
04.2010 - 04.2011
S.S.C -
Central Board of Secondary Education
01.2008 - 04.2009
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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