Reddeppa Avula
Bengaluru
Summary
Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease.
Overview
12
12
years of professional experience
Work History
Billing & Insurance Specialist
Medi Buddy
Bengaluru, India
11.2022 - Current
- Executed validation of final bills and discharge summaries to ensure accuracy and compliance.
- Safeguarded confidentiality of patient financial records and health statuses.
- Monitored pending authorizations to ensure timely resolution of discrepancies.
- Cultivated strong client relationships to uphold exceptional customer service standards.
- Facilitated effective communication among operations, finance, and clinical departments.
- Rectified discrepancies in insurance payments through collaboration with carriers.
- Addressed customer concerns and inquiries on a daily basis.
- Compiled and generated monthly billing and posting reports for management review.
- Resubmitted edited claims following denial to enhance financial performance.
- Safeguarded confidentiality of patient financial records and health statuses.
- Executed eligibility and benefits verification and authorization processes.
- Maintained confidentiality of patient finances, records, and health statuses.
Executive
Sagar Hospitals
Bangalore, India
01.2022 - 11.2022
- Facilitated accurate preparation of final bills to ensure clarity in surgical cost estimates.
- Conducted thorough reviews and adjustments of billing and posting documents to maintain financial integrity.
- Utilized data entry expertise to maintain accuracy in documenting and inputting statements.
- Maintained accurate and up-to-date patient information and medical records to support healthcare operations.
- Engaged with insurance providers to address and rectify denied claims, followed by prompt resubmission.
- Coordinated interactions among patients, insurance providers, and billing office to streamline claims resolution.
- Reviewed and assessed patients' insurance plans to determine deductibles, payments from carriers, and any remaining balances not covered.
- Facilitated accurate claims paperwork documentation and system entry to ensure compliance and efficiency.
Junior Executive
Apollo Hospitals
Bengaluru, India
01.2014 - 01.2022
- Oversaw comprehensive final bill preparation processes, ensuring adherence to CGHS cash insurance standards.
- Evaluated patient needs and delivered accurate surgical estimates to support informed decision-making.
- Resolved insurance-related questions by providing clear and comprehensive information to clients.
- Resolved customer inquiries and concerns consistently to ensure effective communication and support.
- Analyzed customer concerns and collaborated on solutions to effectively resolve disputes.
- Maintained comprehensive and precise records of customer payments to facilitate efficient account management.
- Analyzed and rectified discrepancies in billing and posting documents, enhancing overall accuracy and compliance.
- Performed meticulous data entry to accurately record and input statements into the system.
- Managed patient information systems by filing and updating medical records to support efficient healthcare delivery.
- Collaborated with insurance providers to investigate denied claims and executed necessary resubmission procedures.
- Managed relationships with patients and insurance companies, collaborating with billing office to address inquiries and resolve issues.
- Evaluated insurance coverage for patients, focusing on deductibles, insurance carrier payments, and applicable remaining balances.
- Performed thorough documentation and system entry for claims to maintain accurate records and support operational integrity.
Education
MBA - Business Administration
Mother Theresa College
Palamaneru, India05.2012
B com - computers
Marga Darshini College
Piler, India06.2010
Skills
- Final bill preparations
- Health insurance Advanced
- Settlement determinations Advanced
- Claims Advanced
- Insurance coverage verification Advanced
- Insurance industry experience Advanced
- Prior authorization processing Advanced
- Health Insurance Advanced
Languages
English Advanced
Telugu Advanced
Kannada Upper intermediate
Hindi Intermediate
Timeline
Billing & Insurance Specialist
Medi Buddy
11.2022 - Current
Executive
Sagar Hospitals
01.2022 - 11.2022
Junior Executive
Apollo Hospitals
01.2014 - 01.2022
MBA - Business Administration
Mother Theresa College
B com - computers
Marga Darshini College