S. ShylaMary
Avadi
Summary
Organized and dependable candidate,successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Results-driven leader with extensive experience in claims processing and client support. Proven track record in managing complex claims, enhancing team collaboration, and improving processes to maintain high production and quality standards.
Overview
5
5
years of professional experience
Work History
Senior client partner
ACCESS HEALTHCARE
Chennai
05.2024 - Current
- Handel claims entry in devoted health project
- Key person to Handel DMR, PD, MEMBER PORTAL, WELLNESS BENEFIT
- Have experience of getting paper claims into UB04 AND CMS 1500
- Give shadow section for set of new batch in the end to end process knowledge
- Attend client visit and client calls for the process related points and doubts clarification
- Key person to maintain the 100 of production and quality
- Key person to Handel the refund checks and uncleaned claims
- Act as a active SME in my team for process related works and assing the works and audit the claims for the team
Senior Process Associate
NTTDATA
Chennai
07.2023 - 05.2024
- Handel cases for both Provider and Practitioner
- Enroll all the details for the provider and practitioner according to the source document
- Verify the hat code for practitioner and age limits in RDM tool
- Enroll service locations and additional locations for the provider and practitioner with Phone and Fax number
- Enroll Medicaid ID for the states in Medicaid state file.
Senior Claim processor
Teleperformance
10.2022 - 06.2023
- Specialist in payments and rejection
- Handling Open negotiation letters
- Solving client queries directly in email chat
- End to end knowledge Arbitration
Senior Client partner
Access healthcare
12.2020 - 10.2022
- Key person to checking the patient claims
- Checking the eligibility status for claims
- Verify with card copy with claims and submit the case with kick codes
- Verify with family members information and check the history and ensure the correct insurance
- Work for medicare, Medicaid, cigna, BCBS, aetna UHC, Florida
Education
B.COM - CS
DRBCCCHinduCollege
12th -
Immaculateheartofmarrygirls. higher Secondary school
10th -
Immaculateheartofmarrygirls. higher Secondary school
Skills
- Typing skills
- Basic excel
- Ms office
- Quick learner
- Leadership skills
- Ability to work within TAT
- Ability to work under pressure
- Organizing skill
Hobbies and Interests
- Listening music
- Watching movies
Disclaimer
I hereby declare that the above information is all true to the best of my knowledge and belief.
Languages
- Tamil
- English
- Malayalam
Personal Information
- Date of Birth: 04/23/98
- Gender: Female
- Nationality: Indian
- Marital Status: Unmarried
- Religion: Christian
Languages
English
First Language
Timeline
Senior client partner
ACCESS HEALTHCARE
05.2024 - Current
Senior Process Associate
NTTDATA
07.2023 - 05.2024
Senior Claim processor
Teleperformance
10.2022 - 06.2023
Senior Client partner
Access healthcare
12.2020 - 10.2022
B.COM - CS
DRBCCCHinduCollege
12th -
Immaculateheartofmarrygirls. higher Secondary school
10th -
Immaculateheartofmarrygirls. higher Secondary school