PAILA MOHAN RAO
SRIKAKULAM
Summary
US Healthcare Senior Billing Executive with 2.6 years of hands-on experience in Charge Entry and Rejection management. Skilled in charge capture, CPT/ICD posting, claim quality checks, rejection resolution, and clean claim resubmission to minimize revenue leakage and support efficient RCM operations.
Overview
3
3
years of professional experience
Work History
Senior Process Associate
Elico health care services pvt Ltd
Hyderabad
03.2025 - 01.2026
- Performed charge entry tasks with accurate record keeping.
- Worked on Nextgen Software and Aprima Software.
- Processed the office charges and hospital charges. And DME Billing.
- Reviewed Patient information and self pay and and insurance eligibility checking like Medicare, Medicaid, Triwest authorization.
- Verified Medical codes for diagnosis, Procedure and ICD 10 coding system.
- Created patient Demographics & create batches.
- Worked On E&M Codes and New patient Cpts and Established Cpts, Modifiers 25,26,59,LT,RT.
- Ensured compliance with HIPAA guidelines while handling confidential patient information.
Process Associate
WNS Global services Pvt Ltd.
Visakhapatnam
03.2023 - 05.2024
- Worked as a Process Associate at Promantra Synergy Solutions Pvt. Ltd. from Aug 2024 to Feb 2025, handling claim rejections in US Healthcare Medical Billing.
- Worked on MDM & ESO Software.
- Processed The charges tasks Cms - 1500 billing form. UB - 04 form.
- Performed patient demographics and procedure,modifiers.
- Reviewed and analyzed rejected medical claims from payers.
- Identified rejection reasons such as demographic errors, coding issues, eligibility issues, authorization missing, and timely filing.
- Handled front-end and back-end claim rejections by correcting claim-level errors.
- Corrected claim data including CPT, ICD-10, modifiers, provider, and patient details.
- • Coordinated with eligibility, coding, and AR teams to resolve claim issues.
- Followed payer-specific guidelines and billing rules.
- Resubmitted corrected claims within TAT to minimize revenue loss.
- Maintained rejection reports and tracked resolution status.
- Ensured compliance with HIPAA and billing regulations.
Education
Bachelor of Science - PCM
Kalinga University Raipur.
Raipur 07-2020
Skills
- Microsoft Office Excel
Languages
English
Proficient (C2)
C2
Telugu
Proficient (C2)
C2
Timeline
Senior Process Associate
Elico health care services pvt Ltd
03.2025 - 01.2026
Process Associate
WNS Global services Pvt Ltd.
03.2023 - 05.2024
Bachelor of Science - PCM
Kalinga University Raipur.