Summary
Overview
Work History
Education
Skills
Languages
Accomplishments
STRENGTHS
Declaration
Timeline
Generic

Nandhini K

Coimbatore

Summary

Experienced Insurance Verification and Authorization Specialist with 2 years of expertise in verifying patient insurance coverage and obtaining authorizations for medical procedures. Proficient in utilizing various insurance portals, including Availity, and calling customer service representatives CSRs) to verify coverage and coordinate authorizations. Skilled in navigating insurance systems, resolving discrepancies, and ensuring compliance with regulatory requirements. Recognized for strong communication skills, attention to detail, and commitment to supporting healthcare providers in delivering optimal patient care.

Overview

2
2
years of professional experience

Work History

Process Executive

RND SOFTECH
Coimbatore
05.2022 - Current
  • Conducted insurance verification and eligibility checks using Brightree software for patients undergoing medical procedures
  • Obtained necessary authorizations from insurance companies through Brightree to ensure coverage for treatments and services
  • Ensured compliance with insurance company requirements and guidelines within the Brightree system
  • Managed client inquiries regarding insurance coverage and authorization status via Brightree
  • Provided professional and courteous assistance to resolve client issues and concerns efficiently
  • Collaborated effectively with healthcare providers and insurance company representatives
  • Trained and mentored 4 team members in utilizing Brightree for insurance verification and authorization processes
  • Supported team members in resolving complex authorization issues and optimizing workflow efficiency through Brightree
  • Implemented process improvements in Brightree that streamlined authorization procedures and reduced processing times
  • Contributed to the development and implementation of new procedures within Brightree to meet company goals
  • Maintained accurate records of insurance verification and authorization activities in Brightree
  • Ensured strict compliance with HIPAA regulations and company policies regarding patient information confidentiality through Brightree
  • Prepared detailed reports and documentation within Brightree for audits and quality assurance purposes
  • Received three Best Team Player awards for outstanding teamwork, showcasing my ability to drive team success and foster a collaborative environment
  • These awards recognized my dedication to supporting team goals, enhancing performance, and effectively managing challenges.
  • Maintained quality control standards by monitoring the performance of process operations.

Education

BBA -

Sri Ramakrishna College of Arts And Science
Coimbatore, Tamilnadu, India
04.2021

HSC -

PSGR Krishnammal Higher Secondary School for Girls
Coimbatore, Tamilnadu, India
04.2018

SSLC -

PSGR Krishnammal Higher Secondary School for Girls
Coimbatore, Tamilnadu, India
04.2016

Skills

  • Leadership
  • Problem Solving
  • Availity Portal Expertise
  • Process Mapping
  • CPT and ICD-10 Coding
  • Insurance Verification
  • Clinical Documentation
  • Electronic authorization processing
  • Customer Relationship Management
  • Coverage and Authorizations
  • Insurance terminology
  • Eligibility Determination
  • Medicaid knowledge
  • Attention to Detail

Languages

  • English
  • Tamil

Accomplishments

  • Achieved a 98% accuracy rate in verifying insurance information, significantly reducing claim denials and delays, which improved overall claim processing efficiency and enhanced patient satisfaction
  • Provided exceptional customer service by resolving client issues and inquiries efficiently, leading to a 20% increase in positive feedback from clients

STRENGTHS

  • Analytical Skills: Strong analytical skills for interpreting complex insurance policies and identifying discrepancies
  • Attention to Detail: Meticulous attention to detail, ensuring accuracy in all insurance verification and authorization processes.
  • Leadership and Mentorship: Experienced in training and mentoring team members, enhancing their skills in utilizing Brightree and improving overall team performance.

Declaration

I Hereby declare that all the information provided above is true to the best of my knowledge and belief

Timeline

Process Executive

RND SOFTECH
05.2022 - Current

BBA -

Sri Ramakrishna College of Arts And Science

HSC -

PSGR Krishnammal Higher Secondary School for Girls

SSLC -

PSGR Krishnammal Higher Secondary School for Girls
Nandhini K