PRIYESH DUBEY
KOLKATA
Summary
Results-driven Clinic Operations Specialist with Globe Centrix Associates, skilled in ICD-10 coding and healthcare compliance. Achieved 100% outpatient record accuracy and resolved 90% of denied claims, enhancing revenue capture and patient care. Strong team collaboration and data analysis abilities contribute to improved operational efficiency and patient satisfaction.
Overview
8
8
years of professional experience
Work History
Clinic Operations Specialist
Globe Centrix Associates
10.2023 - 09.2025
- Analyzed over 500 patient charts to identify health histories and enhance treatment accuracy.
- Executed ICD-10, CPT, and HCPCS coding, increasing revenue capture by 95%.
- Achieved 100% compliance in outpatient records through enhanced coding accuracy and improved documentation.
- Collaborated with insurance providers to resolve 90% of denied claims, boosting recovery rates significantly.
- Addressed treatment challenges by analyzing data from 200+ patients' Holter monitors, enhancing personalized care.
- Initiated successful cardiology procedure outcomes, achieving a 90% improvement in recovery rates.
- Optimized scheduling processes to increase patient retention by 90% and adherence rate by 95%.
Account Receivable
Sunknowledge Services Inc
10.2020 - 10.2023
- Processed 90% of claims within 32 hours, ensuring timely and accurate submissions.
- Interpreted outpatient records, achieving 90% accuracy in identifying diagnoses and procedures.
- Collaborated with healthcare professionals to address patient service inquiries, doubling service efficiency.
- Resolved coding discrepancies by partnering with over 50 insurance companies, enhancing claim accuracy by 90%.
- Managed high-priority queue of over 100 denied claims, resolving 95% within 14 days for improved cash flow.
- Audited over 100 documents to resolve billing discrepancies, increasing accuracy by 95%.
Customer Service Representative
Uber India Systems Pvt Ltd
12.2018 - 12.2019
- Enhanced route planning to address low passenger flow, increasing efficiency by 80% and elevating customer satisfaction.
- Enhanced fare calculations to address accuracy issues, achieving a 75% increase in precision.
- Addressed the challenge of high-pressure disputes by resolving 80%, boosting customer satisfaction.
- Resolved 100% of customer issues with 500+ weekly orders, ensuring 100% customer satisfaction.
- Responded to 100% of customer inquiries via phone, email, and chat, resolving issues efficiently and maintaining high satisfaction levels.
- Transformed team performance by training 50+ new customer service associates, resulting in a 91% boost in team productivity.
AR Associate
Omega Healthcare
12.2017 - 04.2018
- Reduced claim denial rates by 1.2% by addressing submission errors through an electronic process.
- Addressed claims denial challenges by efficiently submitting over 500+ electronic claims weekly, enhancing cash flow.
- Resolved 90% of denied claims from Medicare, Medicaid, and third-party insurances by implementing effective follow-up strategies.
- Streamlined the appeals process, addressing challenges of resolution delays, reducing turnaround time by 0.2%.
- Processed 1K+ patient billing inquiries monthly, enhancing accuracy and timeliness of payments.
- Streamlined patient billing processes, addressing billing discrepancies to improve accuracy by more than 94%.
Education
SSC -
PTJM SVM
RAJGIR, BIHARHSC -
DISHA NUCLEUS INSTITUTE
BHAGALPUR, BIHARSkills
- Data interpretation and analysis
- Microsoft Office proficiency
- ICD-10 coding and medical coding
- Claims and revenue cycle management
- Patient scheduling and billing
- Healthcare compliance and documentation
- Team collaboration and communication
- Customer relationship management
- Invoice processing and accounts receivable management
Language
English
Native
Native
Hindi
Proficient (C2)
C2
Timeline
Clinic Operations Specialist
Globe Centrix Associates
10.2023 - 09.2025
Account Receivable
Sunknowledge Services Inc
10.2020 - 10.2023
Customer Service Representative
Uber India Systems Pvt Ltd
12.2018 - 12.2019
AR Associate
Omega Healthcare
12.2017 - 04.2018
SSC -
PTJM SVM
HSC -
DISHA NUCLEUS INSTITUTE