Kiran Kumar Das

Client : Colorado Springs Oct 2020 - Present

Claims Submission & Denial Management : We have created an in-house app to support the Incident Response team to smoothen the Claims process for the Provider and the Payer by managing the list of Claims.

• Provider had a Dashboard view of all the claims along with its status and count.
• Requirement Elicitation & documenting in ADO.
• Managing Stakeholders - Client calls & Demos.
• Defining the Project Plan, along with the Scope & Risk Analysis document.
• Managing a team of 7 to organize Sprint grooming & planning sessions.
• Working on Product Roadmap Planning,
• Handling Change Requests process through proper hierarchy.
• Working on assigned inventory and performing reconciliation.
• Posted transaction in ALLSCRIPT APMS & validated it.
• Audits of internal team and providing them regular feedbacks.

Client : PHCT – Pro Health Connecticut May'17 - Sep'20 Patient Registration & Insurance Verification :Project was aimed at creating a workflow around Patient Registration and Details that would be worked upon by multiple actors during the Health Check up process, It identifies the requisite document to validate whether a patient is eligible for insurance or not as well.

• PI Planning and Sprint Planning for my Scrum team.
• Managing the Sprint Backlog and creating Features & User Stories.
• Creating Test Scenarios and cases & playing active role in UAT Process.
• Documenting requirements to convert BRD into extensive prototypes.
• Worked extensively on Patients Payments, Insurance Payments & Patients Payment through Applications - ALLSCRIPT APMS & validated it.
• Inventory assigned on daily basis through tool named OWM- Ops Work Manager
• Collecting assigned inventory from that tool and worked accordingly.
• Posting payments ERA & Manual in FLOWCAST & EPIC

Claims Associate Jan 2015 - Apr 2017

MD MANAGE INDIA PVT LTD

Ultimed Health Care: The project was all about Posting Payments, Working on Denials, Creating Reports, Checking for Claims eligibility and Pre Authorization and tracking all medical documents in DMS - Document Management Tool.

• Entered patient demographic details.
• Created patient eligibility verification and sent to appropriate department for verification.
• Performed precertification for approval of surgery, physiotherapy and chiropractic.
• Payment posting Manual and ERA.
• Worked on P-care application.