Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Prashant Tripathi

Faridabad

Summary

Detail-oriented team leader with expertise in quality assurance initiatives, issue resolution and interpersonal communication. Ability to handle multiple projects simultaneously with a high degree of accuracy as well as an Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Proficient with project management, personnel training and production scheduling. Sets example for work ethic, punctuality and quality.

Overview

9
9
years of professional experience

Work History

Team Leader

Pacific Health
Noida
03.2024 - Current
  • Allocation of work - Prepare downloads of respective process and allocate the work to the Team Members, and ensure a smooth flow of production through Auto Allocation (Creation of Rules and Implementation).
  • Responsible for supervising the team to work on assigned cases/accounts.
  • Provide subject matter expertise on Accounts Receivable processes.
  • Monitor Team's production and SLA delivery, and the issue logs raised by the client partners, and review each issue log prior to being escalated to the customers.
  • Responsible for Review Reports, review key reports for accuracy and quality. These reports include: Production log (Target Vs. Achieved, Monthly and weekly MTD, Monthly overall performance data, etc.
  • Maximizing overall team performance (Production and Quality). Identifies and resolves the more complex issues around pending transactions.
  • Manage client calls on a weekly basis to discuss the issues and updates related to the process.
  • Manage and handle escalations raised by the clients effectively and lead by example, demonstrating the highest standards of ethical behavior.
  • Continuous connection with client on Teams chat for any live query or concern from onshore and offshore.
  • Keep the Standard Operating Procedures updated and establish due control mechanisms.
  • Work with the quality and business transformation team to identify other stakeholders, recommend, and implement process improvement projects.
  • Responsible for maintaining the adherence scores of accounts in terms of prioritization, decided by the client itself.
  • Successfully increased the productivity of the team, even after the new transition of software.
  • Provided coaching and feedback on employee performance, encouraging professional development.
  • Established clear expectations for employees, providing guidance when needed.
  • Delegated daily tasks to team members to optimize group productivity.

Subject Matter Expert

Coronis Health PVT LTD
Noida
07.2022 - 03.2024
  • Handled team of 10 members working on AR for different states of the United States.
  • Managing team functions like claims allocation, process workflow coaching, quality feedbacks, and Team Daily Huddle.
  • Managing projects such as 90+, 120+ aging, high dollar project, and provider enrollment issue project.
  • Analyze aging control management, Denial management, Appeal project, Underpaid claims, Corrected claims, over 365 days claims with complete general follow-up.
  • Monthly preparation of data with complete information of aging, with high dollar value insurance, claims pending for some trend issue, and provide resolution to get them resolved before crossing TFL.
  • Coordinating and directing communication with onshore clients over emails and calls, or emails, for daily trends and issues.
  • Helping and guiding the team to work on denials, correspondence, rejections, and patient statements with a smooth flow of transitioning.
  • Handling eye care client of tier 1 and handling client with a high level of satisfaction in terms of AR collection, Quality parameter, zero escalation matrix.
  • Provide training to new users on software like Kareo, ECW, Nextgen, MD4, Epic, etc.,
  • Completing all client SLAs and achieving 100% quality and production for the team.
  • Providing cross-training to newly joined people, time to time, as per client requirement.
  • Advise the best plan of action to the bottom performer and help increase the efficiency of the team member.

Customer Care Collection Training Sr. Executive

NTT DATA Global Delivery Services
Noida
07.2018 - 07.2022
  • Completed backlogs of Denial for last 2 years Provide regular updates from client in daily huddle
  • Circulate MOM on daily basis
  • Follow up from insurance regarding backlog and get the accounts resolved to generate revenue for provider
  • Supported different team to clear their backlogs and support them by resolving queries on denials and AR follow up
  • Work with EDI, Clearing House & Support Teams to reduce the AR & causes of AR increment
  • Use to Provide refresher training to team members whenever required
  • Handled the complete Inventory of $65 Million and escalate the issues with resolution to On-Shore clients
  • Circulate Monthly production deficit report and help team to complete MTD production before TAT
  • Find root cause and pattern of denials & discuss them with Managers and Supervisor & suggest the most appropriate solutions for the AR Reduction & increase payment
  • Worked on Correspondence received from insurance as well as charge correction
  • Worked on high dollars claim project and completed project before TAT with 99% Quality.

Sr Account Receivable Executive

Sovereign Health Private Limited
Gurugram
10.2016 - 07.2018
  • Executive AR Collection Follow up with the insurance for the Outstanding & denied claims for timely resolution Trend Analysis
  • Find the root cause of the denials &analyze them to make changes to in billing procedures to reduce the denials from the insurance
  • Work with EDI, Clearing House & Support Teams to reduce the AR & causes of AR increment
  • Discuss the pattern of denials & discuss them with Managers and Supervisor & suggest the most appropriate solutions for the AR Reduction & increase payment
  • Worked on Correspondence received from insurance as well as charge correction
  • Tracked and published reports for disputed inventory
  • Tracked and published report for Appeal Team and Transaction posting team separately
  • Took regular follow-ups from client regarding updates, inventory and quality parameters
  • Improved team performance by giving 100% quality and won best performer awards for 2 quarter
  • Segregation of accounts on which appeals are made and send them for audit for each Client separately
  • Conduct daily huddle for recent client update and work force management to achieve daily target.

Account Receivable Analyst

ELI INDIA
Faridabad
04.2016 - 10.2016
  • Involved in doing eligibility and verification of patient from different insurance company
  • Regular outbound call to different insurance companies or client to take follow-up
  • Use to take follow up on denials done by insurance for different reason
  • Responsible for generating revenue for provider and reducing the 90+ AR
  • Share regular updates from client within the team
  • Generate daily production report for team
  • Regular follow-up with Medicare payer for eligibility and verification of patient
  • Ran a Project to clear Issue log and successfully achieved it
  • Received excellence in process for the implementation of payer model.

Education

B.B.A (CAM) Commerce -

Maharishi Dayanand University Rohtak
08.2013

Intermediate -

CBSE Board Faridabad
04.2010

High School -

CBSE Board Faridabad
03.2008

Skills

  • Advanced MS Office Skills
  • Effective Call Management
  • Attentive Communication
  • Software Proficiency ( Kareo, ECW, Nextgen)
  • Team Leadership
  • Operational Analysis
  • Quality Service Standards
  • Client Engagement Development
  • Workflow Optimization
  • Revenue Generation
  • Account Management
  • Proficient in Problem Analysis
  • Customer Service Excellence

Accomplishments

  • Consistently maintained high customer satisfaction ratings.
  • Quarterly awarded in NTT Data for maintaining quality continue for 6 months.
  • Received reward for Best employee in NTT Data R&R.
  • Received rewards for best performer for 2 quarter in Sovereign Health.
  • Led team to completion of Patient statement Project of 20K account in 1 week, earning recognition from upper management and financial reward.
  • Earned appreciation from director to maintain Monthly adherence score at 82%

Timeline

Team Leader

Pacific Health
03.2024 - Current

Subject Matter Expert

Coronis Health PVT LTD
07.2022 - 03.2024

Customer Care Collection Training Sr. Executive

NTT DATA Global Delivery Services
07.2018 - 07.2022

Sr Account Receivable Executive

Sovereign Health Private Limited
10.2016 - 07.2018

Account Receivable Analyst

ELI INDIA
04.2016 - 10.2016

B.B.A (CAM) Commerce -

Maharishi Dayanand University Rohtak

Intermediate -

CBSE Board Faridabad

High School -

CBSE Board Faridabad

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Prashant Tripathi