Baskaran M

• Analyzed the Provider Claims Receipt, then checked the eligibility for FSA and HSA products, then approved or denied the claim.
• Ensured correct documentation of all claim activities inside the approved system.
• Reviewed medical records, police reports and other documents related to claim investigations.
• Utilized claim handling software to document and manage claim files efficiently.

• Increased customer satisfaction by resolving complex issues and providing exceptional service at all times.
• Increased customer satisfaction by resolving complex issues and providing exceptional service at all times

• Updated and maintained individual provider files, ensuring accurate and up-to-date information to support completion of necessary requirements, resulting in streamlined processes and improved compliance standards
• Analyzed and evaluated the complete educational and training history of the provider, including residencies, fellowships, and specialty board certifications, ensuring adherence to rigorous industry standards and qualifications
• Maintain Internal Provider Grid to Ensure All Information Is Accurate and Logins Are Available
• Update Each Providers CAQH - PSV Database File Timely According to The Schedule Published by CMS Sent report to Manager on Daily basis and as per need
• Apply For and Renew Annually All Provider Licenses; Professional DEA, Controlled Substance
• Complete Revalidation Requests Issued by Government Payers
• To maintain Accurate Provider Profiles on CAQH - PSV Databases
• Assigning Fax and Email to corresponding case
• I have follow-ups more than 60 daily, weekly & monthly reports.