Navin Sharma

• Handled denial management activities including appeals and denial follow-ups for $0-paid and small balance claims.
• Reviewed claims in detail to identify errors, missing information, or payer-related issues and initiated rework as required.
• Performed account reviews and adjustments to ensure accurate balances and correct claim status.
• Coordinated follow-ups and documentation updates to support timely resolution and proper claim closure.

• Worked with quality improvement methodologies such as FMEA, Gemba audits, Workplace Security audits, and TNI to support process efficiency and risk control.
• Conducted calibration, MSV, PKT, and compliance sessions to maintain quality consistency and align teams with process standards.
• Assisted in developing and using tracking tools like Quality EWS, BQ Efficiency Tracker, and performance teasers to monitor trends and team productivity.
• Performed quality audits, feedback sessions, and chair-side evaluations to ensure adherence to guidelines and support continuous team improvement.

• Managed AR follow-ups to reduce aging and improve collections

• Handled authorization workflows and benefit verification

• Worked on denial management and dead inventory analysis

• Reviewed paid vs contracted rates and supported recovery actions.

• Analyze denial trends and identify root causes to ensure accurate claim resubmission

• Recover underpayments by reviewing payer contracts and submitting appeals

• Resolve $0-paid and dead claims through documentation, follow-ups, and escalation

• Ensure compliance with payer guidelines and maintain claim resolution records