Years of professional experience
POLA ADAM
Analyst
Hyderabad,Telangana
Summary
Dedicated and adaptable professional with a proactive attitude and the ability to learn quickly. Strong work ethic and effective communication skills. Eager to contribute to a dynamic team and support organizational goals.
Overview
5
5
2
2
Certifications
Work History
IT Analyst
Infinite Computer Solutions
Bangalore
03.2022 - 12.2022
- Reviewed medical records for accurate and complete patient data.
- Maintained complete confidentiality in accordance with organization and legal requirements.
- Assisted patients in navigating the medical records request process.
- Reviewed and updated customer order information to ensure accuracy of records.
- Supported the audit process of medical records, ensuring compliance with legal and regulatory standards.
- Ensured accurate documentation by inputting patient insurance, demographic and health information into software.
- Diligently transferred and shared patient records with the responsible parties, ensuring accurate communication of essential data.
- Prepared monthly reports summarizing activities related to follow-up processes.
Claims Associate
UNITED HEALTH GROUP
Hyderabad
- Recorded and tracked claim processing activities in compliance with company policies.
- Processed payments for approved claims according to set schedules and procedures.
- Evaluated claims to assess their validity and adherence to policy guidelines.
- Monitored fraud trends and established protocols for detecting suspicious activities necessitating further investigation.
- Reviewed and verified medical records and claimant documents for accuracy and completeness.
- Implemented rigorous quality control measures for submitted claim files.
- Delivered quality customer service to assigned, insured and claimants during claims process for timely customer service.
Enrollment and Billing – Analyst
R1RCM
Hyderabad
- Ensured accuracy of billing information and patient data in reviewed medical records.
- Implemented quality control measures to enhance efficiency of claim processing.
- Streamlined processes and workflows to optimize efficiency in the billing department.
- Contributed to the identification and implementation of process improvements in collaboration with coworkers.
- Handled claim submissions to various insurance companies.
- Reconciled codes against services rendered for increased accuracy.
- Checked claims coding accuracy according to ICD-10 standards.
- Performed data entry of procedure codes, diagnosis codes, and patient information into billing software to streamline invoicing and account management.
- Trained new hires in company policies and accounting systems, optimizing team productivity and efficiency.
Benefit Analyst Associate - Tester
LEGATO HEALTH TECHNOLOGIES
Hyderabad
- Employed at Anthem Insurance.
- Tested Updates related to Provider services as per the Requirements.
- Implemented comprehensive understanding of Providers, place of services, CPT and DX codes for enhanced productivity.
- Achieved efficient and punctual completion of all update tasks and document preparation.
- Streamlined claim processing by handling complete end-to-end procedures such as creating and updating claims, resolving edits, and facilitating smooth adjudication.
- Validated and raised issue log for all claims in accordance with requirements.
- Closely followed issue logs, promptly recreating any issues as needed according to the log's instructions.
- Facilitated the testing process by providing requested prints of created claims in Excel format.
- Enhanced accessibility by transitioning to the Share path location.
- Updated inventory reports.
- Successfully ensured high levels of quality while meeting production targets.
- Fostered a culture of learning and growth by regularly exchanging information with team members.
- Established seamless connection with Clients and consistently met deadlines for delivering essential data.
- Organized Final Document Preparation and submission.
Education
MBA - Finance and HR
Aristotle PG College , Osmania University
Hyderabad06-2015
B. Com - Computers
Lal Bahadur Degree College, Osmania University
Hyderabad07-2013
Intermediate: CSE -
Lal Bahadur Junior College, Board of Intermediate Education
Hyderabad05-2010
SSC -
Mani’s High School, Board of Secondary Education
09-2008
Skills
- Advanced Excel
- Revenue Cycle Management
- Knowledge of the insurance industry
- Understanding of medical codes and terminologies
- Documents preparation
- Problem-solving skills
Affiliations
- i used to play piano
Languages
Telugu
First Language
English
Proficient (C2)
C2
Hindi
Proficient (C2)
C2
Certification
- Advanced Excel
- Typing
Accomplishments
- Received several Monthly and Quarterly Awards for my work dedication.
Timeline
IT Analyst
Infinite Computer Solutions
03.2022 - 12.2022
Claims Associate
UNITED HEALTH GROUP
Enrollment and Billing – Analyst
R1RCM
Benefit Analyst Associate - Tester
LEGATO HEALTH TECHNOLOGIES
MBA - Finance and HR
Aristotle PG College , Osmania University
B. Com - Computers
Lal Bahadur Degree College, Osmania University
Intermediate: CSE -
Lal Bahadur Junior College, Board of Intermediate Education
SSC -
Mani’s High School, Board of Secondary Education
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