Summary
Overview
Work History
Education
Skills
Professional Summary
Accomplishments
Personal Interest
Personal Information
Disclaimer
Timeline
Generic
Rajesh V

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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