Praveen Kumar A.l

Performing regular audits of medical billing processes, focusing on accuracy, completeness, and compliance as per SLA

Give feedback to the BQM User individual .

Feedback given to the team for the top 5 defects.

Call audit will be done and give feedback to how to improve the calls.

Process level finding to improve the Quality .

• Improved AR collections by implementing efficient follow-up processes and maintaining strong client relationships.
• Maintained accurate customer records, including contact information, credit limits, and payment terms, facilitating effective communication and negotiation efforts.
• Facilitated interdepartmental collaboration on projects related to improving overall financial operations efficiency within the organization''s revenue cycle processes.
• Conducted regular analyses of aged receivables to identify areas requiring targeted collection efforts or adjustments in credit policies for optimal results.

· Identifying the root cause for claim denials and analyze the reason for claim rejection,

· Correct the claims and re-file without delay Oversee accounts receivable write-offs, adjustments and payment reversals and Clarifying.

· Deductions, and allowances on payment received Works closely with payer-provider relations representatives.

· Works all denials and corrected claims collaborating with the biller and/or Revenue Cycle Manager,

· insurance payers and or patients on past due account.

· Ensure complete review of claim and forward to correct insurance.

· Contact insurance carriers or other responsible parties to confirm payment dates and details.

· Handle all claims on denials, rejection and no response work queue and follow up.

· Make adjustments to patient and insurance accounts.

· Perform timely and accurate submission of appeals.

• Checked technical designs and drawings for adherence to standards.
• Coordinated with subcontractors ensuring their work met project specifications as well as monitored their progress towards completion deadlines.
• Managed on-site resources effectively, including personnel allocation, equipment utilization, and material storage to ensure smooth project progression with minimal downtime.
• Created work schedules and adjusted as needed to meet project deadlines and keep shifts properly staffed.