Salman Khan
Jaipur,RJ
Summary
- Focused Claims Representative with extensive experience in reviewing, processing, and resolving insurance claims.
- Skilled in assessing claims for accuracy, verifying coverage, investigating discrepancies, and ensuring timely reimbursement.
- Proficient in working with insurance providers, healthcare professionals, and clients to resolve issues and clarify claim details.
- Adept at managing denied or unpaid claims, processing payments, and ensuring compliance with regulatory standards like HIPAA.
Subject Matter Expert and trusted advisor skilled in research, analysis and examination of company technology and standard operating procedures. Interface and collaborate with clients and internal team members, providing consultative enhancement recommendations based on industry research. Improve existing processes, procedures, technical enhancements, resource requirements, and stakeholder engagement procedures to align with strategic goals.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Subject Matter Expert
Knack Global Pvt Ltd
09.2022 - Current
- Mentored junior team members, contributing to their professional growth and development.
- Established best practices for knowledge sharing, fostering a culture of continuous learning and improvement.
- Enhanced team performance by providing expert guidance on critical projects and strategic initiatives.
- Developed effective training materials for diverse audiences, resulting in improved skillsets and increased job satisfaction.
- Streamlined processes to increase efficiency, enabling teams to complete tasks ahead of schedule.
- Optimized subject matter content by conducting extensive research and incorporating industry trends.
- Managed complex projects from inception through completion, delivering high-quality results within tight deadlines.
Senior Account Receivable
Omega Healthcare Pvt Ltd
09.2021 - 09.2022
- Convince the claims company (payers) for payment of their outstanding claims.
- To check the appropriateness of the insurance information given by the patient if it is inadequate or unclear.
- Send reminders and statements regarding overdue payments.
- Resolve and billing discrepancies and ensure accurate account reconciliation.
- Collaborate with internal teams to address customer inquiries and resolve issues promptly.
- Assist in preparing reports on accounts receivable status and aging.
Senior Account Receivable
Isys Softech Pvt Ltd
01.2017 - 04.2021
- Conduct thorough reviews and in-depth analysis of patient accounts to identify billing discrepancies, posting errors, or missing information affecting claim resolution.
- Examine outstanding claims and assess reasons for non-payment by insurance companies, ensuring timely and accurate follow-up procedures.
- Proactively escalate complex or unresolved collection cases to management, adhering to escalation protocols and minimizing delays in resolution.
- Initiate and maintain effective communication with insurance companies and patients to follow up on unpaid or underpaid claims, ensuring all necessary documentation is submitted.
- Manage denied and unpaid claims by analyzing Explanation of Benefits (EOBs), correcting billing errors, and resubmitting claims as appropriate; escalate persistent denials for further review.
- Adhere strictly to HIPAA regulations and internal call quality standards while handling sensitive patient information during claim resolution and follow-ups.
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Education
Master of Science - Computer Science
Jaipur National University
06-2016
Bachelor of Science - Computer Science
Rajasthan University
04-2014
High School Diploma -
Sent Sonam Sr, Sec, School
04-2011
Skills
- Strong analytical skills
- Creative solutions
- Team building
- Teamwork and collaboration
- Decision-making
Languages
Hindi
English
Certification
RSC-IT
Cricket
- My hobby is playing cricket.
- Cricket keeps me fit, active, and happy.
- I enjoy playing cricket with my friends every evening.
Languages
5,5
Certifications
02-2014
Timeline
Subject Matter Expert
Knack Global Pvt Ltd
09.2022 - Current
Senior Account Receivable
Omega Healthcare Pvt Ltd
09.2021 - 09.2022
Senior Account Receivable
Isys Softech Pvt Ltd
01.2017 - 04.2021
Master of Science - Computer Science
Jaipur National University
Bachelor of Science - Computer Science
Rajasthan University
High School Diploma -
Sent Sonam Sr, Sec, School