Rajesh V
Bangalore
Summary
To give my best in every responsibility entrusted to me and utilize knowledge and further.
Overview
8
8
years of professional experience
Work History
Analyst
Getixhealth Pvt Ltd.
Bengaluru
09.2022 - Current
- Good hands-on follow-up, receipt posting, and pre-billing.
- Followed up on submitted claims, monitored unpaid claims, and identified underpaid and unbilled claims, ensuring all necessary corrections and documentation are completed.
- Analyzing claims and managing denials effectively.
- Reviewing the Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA) denials, along with patient history notes, understanding, and resolving discrepancies in claims.
- Tracking and following up on claims due for future review within the designated time frames.
- Communicating with insurance companies to follow up on claims and reimbursement status.
- Documenting and updating patient records regarding billing information and status.
Senior Process Executive
Hinduja Global Solutions Healthcare
05.2017 - 09.2022
- I was working for a semi-voice and non-voice process.
- I was working on claims follow-up for the RCM.
- I worked for all payers, and I also worked for providers (Including Appeals and EOB).
- Re-adjudication of the claim (including all denial management).
- Resolving the processing claims correctly, and releasing payment to the provider by using the CAS tool within the default date.
- Processing the claims as per the clients' requirements.
- Guiding the team when processing related information.
- Having experience in training new users for the process related to client updates.
- Extended to work an extra number of productions when requested by supervisors.
- Following up on the project and closing it within the time limit.
- Responding to the client's mail on a daily basis.
- Based on the outlook of the mail, use it to create cases and document them.
- Reviewing the status of the case and replying to the clients through email.
- Responding to the escalation emails and giving updates to the team.
- Preparing the beginning of the day and end of the day report on a daily basis.
- Maintaining the quality of the process on a daily basis.
Education
B.com -
St. Josephs Evening College
01.2016
PUC -
St. Aloysius PreUniversity
01.2013
10th -
Maria Niketan High School
01.2011
Skills
- MS Excel
- Tally ERP 90
- KYC and Documentation of report
- Research and analysis
Professional Summary
- Have over all 7 years and 8 months work experience in International Healthcare domain for multiple process.
- Have Goods on Payment posting, Receipts posting, Denials, Appeals and Follow up. Demonstrates exceptional research, analysis, and problem-solving skills, successfully managing denials and optimizing claims processing. Known for outstanding team guidance and achieving high-quality standards, significantly improving billing processes and client satisfaction.
Accomplishments
- Organized and led several cultural activities.
- 1st place for Film/Movie Spoof and for Ice Breaker Certificates from SJE College, Bangalore.
- Mr. Discipline for Attendance and Punctuality from Hinduja Global Solutions Pvt. Limited, Bangalore.
- Won 8 Top Gun Award for the monthly outstanding performance on Job from Hinduja Global Solutions Pvt. Limited, Bangalore.
- Stardom Award for maintaining the quality for 1 year in production from Hinduja Global Solutions Pvt. Limited, Bangalore.
- Appreciation received from the Clients for clearing inventory on daily bases and for maintaining TAT in 2018-2019.
Personal Interest
- Interested in Playing and watching Cricket
- Most of my free times I'll be listening to Music.
- Interested in long drive.
Personal Information
- Father's Name: Late G. Venkatesulu
- Mother's Name: Mohana V
- Date of Birth: 04/11/95
- Gender: Male
- Nationality: Indian
- Marital Status: Single
- Languages : English, Kannada, Telugu & Tamil.
Disclaimer
I hereby declare that the above written particulars are true and correct as far my knowledge.
(Rajesh.V)
Timeline
Analyst
Getixhealth Pvt Ltd.
09.2022 - Current
Senior Process Executive
Hinduja Global Solutions Healthcare
05.2017 - 09.2022
B.com -
St. Josephs Evening College
PUC -
St. Aloysius PreUniversity
10th -
Maria Niketan High School
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