RAHUL KARKAL

• Insurance Follow-ups
Call insurance companies to check claim status and push for payment.
• Denial Management
Analyze denied claims, understand reasons, and take corrective actions (resubmission, appeals, etc.).
• Payment Posting Clarification
Verify payments, underpayments, and discrepancies with insurers.
• Accounts Receivable Analysis
Review aging reports (30/60/90+ days) and prioritize high-value or overdue claims.
• Appeals & Reconsiderations
Prepare and submit appeals for rejected or underpaid claims.
• Documentation
Accurately update call notes, claim status, and actions taken in billing software.

• Analyzing claims which were denied for what reasons whether the denial is correct or not according to that I needed to take action.
• If the claim is denied incorrectly, I need to call the insurance company and make them understand it was incorrectly denied to get it reprocess and should be paid.
• I have worked for two clients which are as follows: 1. Geriatric consultants 2. Great rivers behavioral health organization.
• Resolving issues, Identifying the root cause of non-payment, taking corrective action, and using web-based payer resources.

• Adhering to client, payer, and state and federal rules, and complying with the organization's Acceptable Usage policy.
• Analyzing claims Understanding the reasons for rejected or denied claims and reprocessing them for payment.
• Meeting targets, following up on pending claims and coordinating with the group coordinator or team leader in the AR process.
• Resolving issues, Identifying the root cause of non-payment, taking corrective action, and using web-based payer resources or phone calls to resolve AR.

• Accurately completed with company guidelines and procedure.
• Experience in working to and achieving set targets and KPI's.
• Provided customers with relevant information about personal loan.
• Connected with existing and potential customers and aims to turn every call into a sales opportunity.