Summary
Overview
Work History
Education
Skills
Contactdetail
Personal Information
Certification
Languages
Timeline
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Mayur Khandare

Mayur Khandare

Thane

Summary

Dynamic professional with a proven track record at AGS Health PVT. Ltd, excelling in data reporting and root cause analysis. Adept at enhancing productivity and resolving complex claims issues, I leverage strong problem-solving skills to drive process improvements and ensure regulatory compliance. Committed to delivering quality results and fostering team collaboration.

Overview

4
4
years of professional experience
1
1
Certification

Work History

Trainee Team Leader

AGS Health PVT.Ltd
Jaipur
12.2024 - Current
  • Coordinated workload and performance reviews for billing team, enhancing monthly productivity and quality.
  • Ensured successful completion of daily electronic claim submissions on Change Healthcare.
  • Monitored unpaid claims and initiated timely follow-ups to expedite resolutions.
  • Generated comprehensive reports including daily, weekly, and monthly data for HRSA Reimbursement Program.
  • Handled escalated claims issues, providing efficient solutions to complex problems.
  • Prepared and submitted weekly HRSA COVID Reimbursement report to maintain compliance.
  • Conducted monthly sliding fee audits to verify accuracy and adherence to guidelines.
  • Reviewed and approved refund requests to ensure proper financial handling.

Quality Analyst

AGS Health PVT.Ltd
Jaipur
03.2024 - 12.2024
  • Conduct thorough root cause analyses on recurring defects: conduct a detailed analysis to identify the underlying causes of recurring defects, and develop effective corrective actions to address them.
  • Provide detailed reports on quality metrics to senior management: prepare and present comprehensive reports on quality metrics to senior management, enabling them to make informed decisions regarding process improvements.
  • Provide regular updates to team leadership on quality metrics: regularly update team leadership on quality metrics, highlighting any consistency problems or production deficiencies that need attention.
  • Collaborate with cross-functional teams to develop and implement targeted solutions: work closely with cross-functional teams to develop and implement targeted solutions for identified quality issues, ensuring continuous improvement.

Accounts Receivable

ViewGol HealthCare
Mumbai
12.2022 - 03.2024
  • Calling insurance companies on behalf of the facility: contact the insurance companies in the US to inquire about the status of outstanding accounts receivable. ensure that I follow the international norms and applicable rules for confidentiality and HIPPA compliance.
  • Carry out further examination on outstanding accounts receivable: conduct a thorough examination of the outstanding accounts receivable to identify any discrepancies or issues that need to be addressed.
  • Follow up with the payer on denial and rejected claims: follow up with the payer via emails, chat, web portal, and outbound calls to resolve any denial and rejected claims. ensure that I escalate any difficult collections situations to management in a timely manner.
  • Ensure accurate financial reporting: review account classifications and ensure proper allocation of expenses to ensure accurate financial reporting.
  • Maintain proper data for future reference: maintain accurate and up-to-date records of all interactions with insurance companies and clients, including call logs, emails, and chat transcripts.
  • Reduce late payments: work to reduce late payments by maintaining strong relationships with clients and implementing effective follow-up procedures.

Senior Accounts Receivable

Gebbs HealthCare Solutions
Mumbaipur
06.2021 - 07.2022
  • Update daily work reports: review and update the daily work reports to ensure they are accurate and up-to-date. also make sure to include any new information or updates that need to be reflected in the reports.
  • Address new joiners' queries: reach out to the new joiners and address any queries or concerns they may have. provide them with the necessary information and support to ensure a smooth onboarding process.
  • Analyze accounts: conduct a thorough analysis of the accounts to identify any discrepancies or areas that require attention. also review the financial statements and ensure that all transactions are accurately recorded.
  • Call insurance for claim status: contact the insurance company to inquire about the status of the claims. follow up on any outstanding claims and ensure that they are being processed in a timely manner.
  • Convert denied claims into payments: review the denied claims and work with the insurance company to resolve any issues that led to the denial. also ensure that the necessary documentation is submitted to support the claims and work towards converting them into payments.

Education

Higher Secondary Certificate (HSC) -

Aadarsh Coaching Institute
Mumbai, India
2019

Diploma In Computer -

Grand Computer Education
Mumbai, India
2017

Secondary School Certificate (SSC) -

Aadarsh Coaching Institute
Mumbai, India
2015

Skills

  • Data reporting
  • Root cause analysis
  • Claim resolution
  • Regulatory compliance
  • Team coordination
  • Customer relationship management
  • Process improvement
  • Quality assurance
  • Problem solving
  • Accounts reconciliation

Contactdetail

9167698688

Personal Information

Certification

  • Principles of Retailing
  • Leadership and Motivation in Organization
  • Advanced Excel
  • Human Resource Management

Languages

English
Advanced (C1)
C1
Hindi
Proficient (C2)
C2
Marathi
Native
Native

Timeline

Trainee Team Leader

AGS Health PVT.Ltd
12.2024 - Current

Quality Analyst

AGS Health PVT.Ltd
03.2024 - 12.2024

Accounts Receivable

ViewGol HealthCare
12.2022 - 03.2024

Senior Accounts Receivable

Gebbs HealthCare Solutions
06.2021 - 07.2022

Higher Secondary Certificate (HSC) -

Aadarsh Coaching Institute

Diploma In Computer -

Grand Computer Education

Secondary School Certificate (SSC) -

Aadarsh Coaching Institute

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Mayur Khandare