Nickson A C
Dhubri
Summary
Experienced professional in the US health insurance field with a robust background in accounts receivable, revenue cycle management, and claims adjustment. Proven track record of efficiently managing hospital billing processes, resolving complex claim issues, and ensuring compliance with regulatory requirements. Adept at using specialized software to maintain accurate records and enhance operational efficiency. Strong analytical, problem-solving, and communication skills, combined with a commitment to providing exceptional customer service.
Overview
14
14
years of professional experience
Work History
Transaction Processing Senior Associate
Conduent Business Services LLP
Kochi
12.2020 - 10.2023
- Oversaw the processing and adjustment of complex health insurance claims, ensuring accuracy and compliance with industry standards.
- Conducted thorough reviews and analyses of claim documentation to identify discrepancies, errors, and potential fraud.
- Collaborated with insurance companies, healthcare providers, and policyholders to resolve claim issues and discrepancies.
- Utilized advanced claims processing software to update, track, and maintain accurate records of claim adjustments.
- Implemented process improvements to enhance efficiency, accuracy, and turnaround times in the claims adjustment process.
Accounts Receivable Process Associate
Exl, Outsourcepartners International Private Limited.
Kochi
06.2015 - 01.2018
- Managed hospital billing processes, ensuring timely and accurate submission and follow-up of insurance claims.
- Contacted insurance companies on behalf of hospitals to verify claim status through calls and online portals.
- Investigated and resolved claim denials, rejections, and discrepancies to secure maximum reimbursement for hospital services.
- Collaborated with hospital billing departments to gather necessary information and documentation for claim processing.
- Utilized billing and RCM software to track, update, and maintain accurate patient and financial records.
- Ensured compliance with healthcare regulations, insurance policies, and company procedures in all AR activities.
Transaction Processing Associate
Xerox Business Services India Private Limited
Kochi
01.2010 - 06.2015
- Achieved efficient and precise processing of numerous health insurance claims and transactions.
- Analyzed and validated claim information, ensuring compliance with company policies and regulatory requirements.
- Conducted thorough reviews of claim documentation to identify errors, omissions, or potential fraud, and escalated issues as needed.
- Assisted in the development and implementation of process improvements to enhance efficiency and reduce processing times.
- Delivered exceptional customer service by professionally addressing inquiries and concerns from policyholders and other stakeholders in a courteous manner.
Education
Batchelor of Commerce - Computer Application
Mahatma Gandhi University
Kerala, India03-2013
Skills
Technical Skills:
- Claims Processing Software, Epic
- Revenue Cycle Management Systems
- Data Analysis
- Medical Coding and Billing (ICD-10, CPT, HCPCS)
- Microsoft Office Suite (Excel, Word, PowerPoint)
- Electronic Health Records (EHR)
- Problem-Solving
- Attention to Detail
- Data Interpretation
- Customer Service
- Negotiation
- Team Collaboration
- Time Management
- Prioritization
- Documentation
- Compliance
- HIPAA
- Empathy
- Conflict Resolution
Accomplishments
Star Performer, Quarter 2, 2016,
Exl, Outsource partners International Private Limited.
Recognized for outstanding performance and contributions in revenue cycle management.
Languages
Malayalam
First Language
English
Advanced (C1)
C1
Timeline
Transaction Processing Senior Associate
Conduent Business Services LLP
12.2020 - 10.2023
Accounts Receivable Process Associate
Exl, Outsourcepartners International Private Limited.
06.2015 - 01.2018
Transaction Processing Associate
Xerox Business Services India Private Limited
01.2010 - 06.2015
Batchelor of Commerce - Computer Application
Mahatma Gandhi University
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