Summary
Overview
Work History
Education
Skills
Additional Information
Interests
Work Availability
Timeline
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Khushboo Gupta

Khushboo Gupta

Sr. Claims Representative
Delhi

Summary

To implement my knowledge and skills in an organization to contribute in their growth and success by providing the solutions of the challenges faced by them. Also attaining new knowledge & skills sets from people I work with and increase my experience. Friendly and upbeat team player with organized and disciplined approach. Organized, driven and adaptable with excellent planning and problem-solving abilities. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

4
4
years of professional experience
6
6
years of post-secondary education
2
2
Languages

Work History

Sr. Claims Reresntative

Optum Global Solutions
Noida
08.2022 - 08.2023
  • Good analytical, investigating skill and problem-solving abilities.
  • Verify insurance of patient to determine eligibility, utilizing various websites.
  • Research and resolve issues with common causes of delays.
  • Ensure complete review of claims and forward to correct insurance companies.
  • Contact insurance carriers or other responsible parties to confirm payment dates and details.
  • Perform timely and accurate submission of claims.
  • Supports and assists team members.
  • Maintain a current working knowledge of all healthcare related issues and regulations.
  • Calling insurance companies to get status of unpaid claims.
  • Update, correct and rebill medical claims according to proper billing guidelines.
  • Performs other related projects and duties as assigned.

Sr. Analyst-AR

Pacific an Access Healthcare
Noida
11.2021 - 07.2022
  • Checked patient insurance, demographic, and health history to keep information current.
  • Experience with medicare, medicaid and all commercial insurances.
  • Appeals process for denied claims charge entry and payment posting.
  • Perform timely and accurate submission of claims.
  • Contact insurance carriers or other responsible parties to confirm payment dates and details.
  • Ensure complete review of claims and forward to correct insurance companies.
  • Research and resolve issues with common causes of delays.

Sr. Analyst

R1RCM
Gurugram
09.2019 - 10.2021
  • Identified and resolved problems through root cause analysis and research.
  • General insurance understanding
  • Helped the collections team identify billing issues
  • Ensure complete review of claims and forward to correct insurance companies
  • Contact insurance carriers or other responsible parties to confirm payment dates and details.
  • Handle all claims on denials, rejections, Holds and no response workqueue and follow up, review and document accordingly.
  • Make adjustments to patient and insurance accounts as per the client given projects.
  • Experience with medicare, medicaid and all commercial insurances.
  • Appeals process for denied claims charge entry and payment posting

Education

Bachelor of Arts -

Delhi University
New Delhi. India
05.2015 - 10.2018

MBA -

Sysmbiosis Centre For Distance Learning
Pune, Maharashtra
07.2021 - Current

Skills

    Documentation review

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Additional Information

- Worked experience on tools e.g: Athena, EDI rejections, All Script (PM), Cerner, EHR, NWM, Waystar

- Worked Experience into Physician billing (CMS1500) and Hospital billing (UB04).

- Worked on denials, rejections, hold codes, portal claims, appeal preparation, authorization, multiple project work

Interests

Singing

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline

Sr. Claims Reresntative

Optum Global Solutions
08.2022 - 08.2023

Sr. Analyst-AR

Pacific an Access Healthcare
11.2021 - 07.2022

MBA -

Sysmbiosis Centre For Distance Learning
07.2021 - Current

Sr. Analyst

R1RCM
09.2019 - 10.2021

Bachelor of Arts -

Delhi University
05.2015 - 10.2018
Khushboo GuptaSr. Claims Representative