SAMBHU B. R
Kollam
Summary
Dynamic QA Analyst with a proven track record at Guide House, excelling in auditing and performance evaluation. Skilled in claim analysis and compliance auditing, I enhance team efficiency through targeted training and process improvements. Passionate about driving results and fostering collaboration to achieve outstanding outcomes in healthcare operations.
Overview
6
6
years of professional experience
1
1
Certification
Work History
QA Analyst
Guide House
Trivandrum
06.2024 - Current
- Monitor and evaluate AR callers' performance through audits.
- Analyze data to identify areas for improvement.
- Provide feedback and training to AR callers based on evaluation results.
- Develop and implement process improvements to enhance call efficiency.
- Ensure compliance with healthcare industry standards and regulations.
- Prepare reports on quality and performance metrics.
Senior Associate
Guide house India Pvt. Ltd
Trivandrum
08.2019 - Current
- Responsible for calling insurance companies (in the U.S.) and following up on outstanding accounts receivable.
- Outbound calls to insurance companies for claim status and eligibility verification.
- Should have basic analytical skills that would help analyze a claim and understand the reasons for its unpaid status, underpaid status, or denial status, and initiate appropriate action.
- Denial documentation and further action.
- Calling the insurance carriers based on the appointment received by the clients.
- Working on the outstanding claims reports, account receivable reports received from the client, or generated from the specific client software.
Education
Bachelor of Technology - Electronics & Communication
Kerala University
India01.2009
Higher Secondary -
GHSS Palayamkunnu
Trivandrum, Kerala, India01.2005
High School -
SKVHS Kadampattukonam
Trivandrum, Kerala, India01.2003
Skills
- Claim analysis
- Data analysis
- Call auditing
- Performance evaluation
- Compliance auditing
- Team collaboration
- Training and development
Certification
- MS OFFICE (EXCEL, POWER POINT & WORD).
- KEYBOARD TYPING SKILL SOFTWARE.
Languages
Languages known: English, Malayalam, Hindi.
Disclaimer
I hereby declare that the above-mentioned information is correct up to my knowledge and I bear the responsibility for the correctness of the Mentioned.
Timeline
QA Analyst
Guide House
06.2024 - Current
Senior Associate
Guide house India Pvt. Ltd
08.2019 - Current
Bachelor of Technology - Electronics & Communication
Kerala University
Higher Secondary -
GHSS Palayamkunnu
High School -
SKVHS Kadampattukonam