Poonam Sharma
Gurgaon
Summary
People-oriented team leader successful in monitoring performance, delegating work and motivating members. Versed in managing daily direction and team communication. Collaborative and resourceful professional dedicated to identifying needs to develop and deliver creative solutions. Analytical professional with technical knowledge and critical thinking skills to thrive in data-driven environments. Tackles challenges with positivity and drive to overcome. Works great alone or with others and consistently exceeds expectations.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Group Lead -Posting Voice
Access Healthcare
2022.10 - Current
- Currently working as a group lead with Access Healthcare with a team of 25 members
- The primary responsibility is to maintain and monitor the team performance and reports on metrics
- To delegate the workload among the team members and to delevop and implement a timeline to achieve targets.To conduct coaching and one on one meetings with the members to understand and resolve their concerns and motivate the team members the maximize their potential
- To manage day to day activities of the team including team huddles, team reports, conducting training
- Motivating the team to achieve organizational goals and to adhere quality standards as per Clients SLA
- Conducting performance reviews on timely period
- Empowering team members with skills to improve their confidence, product knowledge and communication skills
- To conduct RCA for quality error with the partners to understand the root cause for each and every error for improvising service quality
- To conduct LVA training and auditing team calls on a regular basis to improvise communication skills of the team members
- Maintaining the team shrinkage and attrition and also to ensure a good and pleasant environment that inspires the team
- To handle client escalation and to create and implement waterfall technique with the available stock to reduce the Claim volume and maintain inflow and outflow of claims.
Medcloud Software Solutions
2020.02 - 2022.09
- Initally, worked in a AR-Collection Procees and handled DME claims for OON provider for IO process
- Gained knowledge to negotiate with the insurance company for the low payments and SCA
- Involves in finding billing trends as per the Insurance policy updates for DME provider and engaged in understanding the root cause for the denial and shared with the concern department to minimize future denial claims and ensure to get the claims resolved and paid
- Later, got promoted as a Team Lead for Nulife Process for denial management, EOB forensics and Appeals Department
- Managed NuLife, in accordance with Client handling, Email and client meetings, Team training and also involved in team Production and quality to meet Service Level Agreements
- Also maintained Team’s KPI and maintaining various team and client reports including QPR report, monthly reports, etc
- Handled PPW Provider Patient Calling to ensure and adhere the quality standards are delivered to Client for Inbound Patient Calls.
Senior Client Service Executive
Scio Management Solutions
2018.08 - 2020.01
- Worked for end to end process for physician claims for multiple process including HRCC, PPA, HOC and handled all types of professional claims including Federal, Commercial, BCBS, WC and detention centre claims
- Being an end to end process, gained knowledge for obtaining patient eligibility and getting an retro authorization if possible for the denied auth claims
- Also made appeal and clinical documentation packets to forward to the insurance via fax or mail
- Has a good knowledge of CMS 1500 form and was worked with ARIA, intergy, ECW softwar for processing of claims
- Along with that, provided basic RCM training to the newbies and trained them with the AR process.
AR Caller Trainee
Vee Technologies
2017.09 - 2018.07
- Worked as a AR caller to handle denial management for hospital billing and resolves denied claims
- And followed up with the insurance for an outstanding claims to get resolved
- The primary responsibility was to work on all types of denials and carrying out further examination related to denial by calling insurance companies
- Gained knowledge of Centricity software and UB 14 form and also the working structure of RCM in medical billing
- Gained minimal knowledge for different CPT codes related to ICD codes with the modifiers used.
Process Associate- Indigo Process
Interglobe Technologies
2016.07 - 2017.09
- Engagee in handling Flight related queries of the passengers and resolve their issues with appropriate and better resolution
- Later, transferred to Net Promoter Score as in Feedback department to measure customer satisfaction and mapping the customer issues to the right department to resolve.
Education
B. Tech in Aeronautical Engineering -
Bharath University
01.2018
Intermediate -
KHSS School
01.2014
Matriculation -
KHSS SCHOOL
01.2012
Skills
- Leadership: Staff management, training, mentoring, Performance management,
- Data Analysis: KPI monitoring, performance reporting, data-driven decision making
- Process Optimization: Workflow analysis, process redesign, efficiency improvements
- Client Management: Relationship building, issue resolution, service customization
- Compliance: HIPAA, CMS guidelines
- Medical Billing & Coding: ICD-10, CPT, HCPCS
- Technical Proficiency: Athena, ARIA NuLife, Intergy, Citrix, Salesforce, E-Clinical Works, EHR/EMR systems,EDI (availity &NaviNet), MS Office Suite
Affiliations
- Production Monitoring
- Coaching and Mentoring
- Employee engagement
- Performance monitoring
- Schedule Management
- Decision Making
- Organization and project management
- Listening Skills
- Emotional Intelligence
- Regulatory Compliance
Certification
- Lean Six Sigma Green Belt
- Basics of HIPAA compliance
- Medical Coding In-Patient - DRG
- Medical Coding In- Patient - PCS
Languages
Hindi
First Language
English
Advanced (C1)
C1
Tamil
Intermediate (B1)
B1
Key Result Areas
- Implemented strategies designed to improve efficiency.
- Facilitated creative problem solving sessions to generate innovative solutions to challenges.
- Identified training needs for group members; provided instruction when appropriate.
- Developed and implemented group activities to promote team building and collaboration.
- Enforced organizational policies while creating an environment that encourages open dialogue.
- Created detailed plans outlining procedures and timelines for successful completion.
- Planned work schedules based on individual strengths, weaknesses, job requirements.
- Organized weekly meetings to review objectives, discuss accomplishments, and plan future goals.
- Conducted regular performance reviews with team members, providing constructive criticism when necessary.
- Monitored progress on projects, providing feedback and support as needed.
- Maintained a high level of communication between group members and other departments.
- Implemented improved initiatives to optimize safety and quality.
- Coached and developed direct reports to lead problem-solving activities.
- Facilitated training sessions for team members to improve skills and productivity.
Accomplishments
- Led initiatives that increased billing accuracy, resulting in [specific financial or operational impact. Achieved increase in client satisfaction by streamlining billing processes and improving communication.
- Recognized for enhancing team efficiency through targeted training and process improvements, reducing average processing time.
References
References available upon request.
Timeline
Group Lead -Posting Voice
Access Healthcare
2022.10 - Current
Medcloud Software Solutions
2020.02 - 2022.09
Senior Client Service Executive
Scio Management Solutions
2018.08 - 2020.01
AR Caller Trainee
Vee Technologies
2017.09 - 2018.07
Process Associate- Indigo Process
Interglobe Technologies
2016.07 - 2017.09
B. Tech in Aeronautical Engineering -
Bharath University
Intermediate -
KHSS School
Matriculation -
KHSS SCHOOL
- Lean Six Sigma Green Belt
- Basics of HIPAA compliance
- Medical Coding In-Patient - DRG
- Medical Coding In- Patient - PCS
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