Pamula Kranthi Kumar
Hyderabad
Summary
I have Experience in US health care in RCM end to end process such as patient registration, demography entry, Insurance eligibility and benefits verification, charges entry, claims submission,payment posting (ERA,ACH and check payments and patient payment), denial management, clearing house rejections, patient statements, Knowledge with ICD-10 CM and CPT'S analytical and flexible approach to solving problems. Hands-on professional offering a keen understanding of data confidentiality and HIPAA regulations. Highly trained Medical Coder and Billing knowledgeable in AMA and the CMS coding rules.
Overview
9
9
years of professional experience
Work History
Senior Associate
Medico Health care services and technologies
Hyderabad
08.2019 - 06.2024
- Claims and appeal Submission Process and worked on CMS-1500 claims,UB04 claim and Worker's Compensation claims
- Reviewed patient insurance information to ensure accuracy and completeness of claims submission.
- Submitted claims to insurance companies.
- Completed and submitted appeals for denied claims.
- Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
- Insurance Eligibility verification and demos entry.
- Payment posting
- Denial Management
- Claims rejections
- Charges entry
Sr Process Associate
Vision 2k India LLP
Hyderabad
09.2015 - 06.2019
- Claims and appeal Submission Process and worked on CMS-1500 claims,UB04 claim and Worker's Compensation claims
- Reviewed patient insurance information to ensure accuracy and completeness of claims submission.
- Submitted claims to insurance companies.
- Completed and submitted appeals for denied claims.
- ICD-10 CM and CPT's analytical and flexible approach to solving problems.
Education
B-Pharmacy - Pharmacy
Sree College of Pharmacy,Kakatiya University
Kothagudem, Telangana, India08-2015
Intermediate - Bipc
APSWRS Jr College, State Board of Intermediate Education
Teleganalanga, IndiaTelangana03-2011
S.S.C -
ZPSS , State Board of Secondary Education, AP
Andhrandhra Pradesh, India03-2009
Skills
- Anatomy and physiology
- Payment posting
- Insurance Verification
- Revenue Cycle Management
- Training and mentoring
- Clinical Documentation
- Data Verification
- Knowledgeable in E-clinical works
- Knowledgeable in Advanced Md
- Knowledgeable in Allscripts PM
- Knowledgeable in MD Care
- Knowledgeable in MD Logic
- Knowledgeable in Practice Fusion
- Medical Billing
- Claims Processing
- Coding Error Resolution
- Patient data identification
- Healthcare claim coding
- Patient Billing
- Commercial and Private Insurance
- Account Reconciliation
- Billing and Collection Procedures
- Claim review
- Insurance claims processing
- Patient Collections
- Submission of medical claims
- Worker's Compensation Knowledge
- CMS-1500 Billing Forms
- CPT code modifiers
Personal Information
- Father's Name: Durga Rao
- Date of Birth: 05/23/1993
- Gender: Male
- Nationality: Indian
Strengths Skills
Quick learning, Time management & Hard working
Languages
Telugu and English
Hobbies and Interests
Listening music, Watching News & reading books
Declaration
I hereby declare that the information furnished above is true to the best of my knowledge.
Pamula Kranthi Kumar.
Timeline
Senior Associate
Medico Health care services and technologies
08.2019 - 06.2024
Sr Process Associate
Vision 2k India LLP
09.2015 - 06.2019
B-Pharmacy - Pharmacy
Sree College of Pharmacy,Kakatiya University
Intermediate - Bipc
APSWRS Jr College, State Board of Intermediate Education
S.S.C -
ZPSS , State Board of Secondary Education, AP
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