Nitin Parashar
Bulandshahr
Summary
Accomplished U.S. healthcare professional with expertise in accounts receivable denial management, CPT coding, and adherence to LCD/NCD guidelines. Skilled in authorization processes for durable medical equipment (DME), including walkers, manual and power wheelchairs with tilt and recline features, hospital beds, and home ICU setups. Proficient in reviewing medical documents such as progress notes, visit notes, and physical therapy notes. Recognized for effective communication with healthcare teams, ensuring streamlined workflows and enhanced patient care. Committed to optimizing operational efficiency and supporting high-quality healthcare delivery.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Intake Co-coordinator/Medical Document Reviewer
InfimedSolutions/UniversalMed supply
Ahmedabad
05.2023 - Current
- Reviewing patient medical records, including current illness, past medical and surgical history, diagnoses, and durable medical equipment (DME) prescriptions, to ensure patients meet all medically necessary criteria established by Medicare under LCD/NCD guidelines. Responsible for qualifying patients for durable medical equipment, such as electric wheelchairs and home ventilators, and submitting documentation to insurance for authorization.
- Discussing Clinical papers with Doctors, Nurse practitioner, Nurses and Medical Assistant and making appropriate changes as recommended by Certified Professionalists
- Conducting patient interviews to identify the most suitable power wheelchair for their needs, as well as responding to their inquiries and providing updates on product-related matters through calls
Senior AR Associate
Pacific BPO, An Access Healthcare company
Noida
02.2022 - 02.2023
- Denial Analysis: Review denied claims to understand the reasons for denial, such as coding errors, lack of medical necessity, or incomplete documentation.
- Appeals Process: Prepare and submit appeal letters to insurance companies, providing necessary documentation and evidence to support the claim.
- Communication: Liaise with healthcare providers, insurance companies, and patients to clarify issues related to claims and facilitate resolution.
- Documentation: Maintain accurate records of denied claims, appeals submitted, and outcomes to track trends and improve processes.
Account Receivables
MedRCM360
Visakhapatnam
01.2020 - 02.2022
- Followed up on claims for collection of payments and worked on denied claims
- Handled day-to-day claim rejections coming through clearinghouse and payers
- Worked for US hospitals to review patient medical records and send them to insurance companies
Intern
Central Research institute
Kasauli
07.2018 - 07.2018
- Hands on training on vaccine preparation in GLP labs
- Preparing and reviewing the effectiveness of clinical data of vaccine injected in Animals
- Worked on equipment like HPLC, Gel-electrophoresis, Autoclave
Education
B.Tech - Biotechnology
Lovely Professional University
Jalandhar, PB01.2020
Intermediate - Medical
Chandrawati Public School
Siyana, UP01.2016
High School - PCMB
Ram Kishan Institute
Ghaziabad, UP01.2013
Skills
- MS Office
- MS Excel
- US insurance
- EHR Software
- EPIC
- Kareo
- Chiro
- Dr Chrono
- Azalea
- Medics
- Claim manager pro
- IMS
- Medcloud
- UMS
Certification
- Participated and represented The State of Rajasthan and Country Indonesia in one world/india Event organised by Lovely Professional University.
- Participated In Spectra Event organised by Lovely Professional University.
- Participated in Making a new Guinness world record in Dance form Bhangra organised by Lovely Professional University.
- Attended Workshop on Scientific Writing organised by Central Research Institute.
- Attended workshop on Intellectual property rights organised by Lovely Professional University.
Languages
Upper Intermediate, Advanced
Languages
Hindi
First Language
English
Upper Intermediate (B2)
B2
Timeline
Intake Co-coordinator/Medical Document Reviewer
InfimedSolutions/UniversalMed supply
05.2023 - Current
Senior AR Associate
Pacific BPO, An Access Healthcare company
02.2022 - 02.2023
Account Receivables
MedRCM360
01.2020 - 02.2022
Intern
Central Research institute
07.2018 - 07.2018
B.Tech - Biotechnology
Lovely Professional University
Intermediate - Medical
Chandrawati Public School
High School - PCMB
Ram Kishan Institute
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