Hi, I’m
Shagun Yadav
Accounts Receivable (Medical Claims)
Delhi,Delhi
Summary
Detail-oriented professional with a focus on deadlines and the assurance that all medical billing is handled efficiently and without errors. Confident claim knowledgeable in data confidentiality and privacy practices when reviewing patient information. Positioned to investigate, evaluate, and settle medical claims. Communicate with insurer to gain details for processing claims.
Overview
4
years of professional experience
3
years of post-secondary education
4
Certificates
4
Languages
Work History
PrimEra Medical TechnologiesTelangana, hyderabad
Senior Analyst
12.2022 - Current
Job overview
- Resolved medical claims by approving or denying documentation, calculating benefit due and initiating payment or composing denial letter.
- Examined medical treatment records and medical bills to gauge overall extent of liability.
- Documented medical claim actions by completing forms, reports, logs and records.
- Evaluated insurance policies and analyzed damages to determine coverage.
CODITECH SOFTWARE SOLUTIONS A Corrohealth CompanyNoida, Uttar Pradesh
Sr. Executive Ar Calling
06.2022 - 08.2022
Job overview
- Created spreadsheets using Microsoft Excel for daily, weekly and monthly reporting .
- Identified issues, analyzed information and provided solutions to problems.
- Created plans and communicated deadlines to complete projects on time.
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
- Developed and maintained courteous and effective working relationships.
- Documented support interactions for future reference.
- Experienced in all type of claim denials .
Tata Consultancy ServicesGurgaon, Haryana
Process Associate
03.2021 - 01.2022
Job overview
- Worked on CMS-1500 and UB-04 for denied claim on almost all the payors including commercial .
- Managed new joiners production and quality during ramp up also maintained their data on weekly basis.
- Worked with steward healthcare where needed to track of production, distribution of production and achieved daily target .
- Checked quality and supported team as trainer
- Experienced on Meditech tool to maintain optimum levels of communication to effectively and efficiently complete projects.
- Interaction with clients, insurance companies, team handling, maintain client data on daily basis .
- Identified issues, analyzed information and provided solutions to problems.
- Delivered project to client within specific timeframes.
R1RCM Global Pvt.LtdGurgaon, Haryana
Senior Analyst
02.2019 - 02.2021
Job overview
- Certified with CCDP level 1 training (3 months) in AR(Accounts Receivable).
- Experienced in claim denial like duplicate, missing information,limit for filing expired, not covered by payor, CLIA, AUTH, AOB.
- Experienced in providing training to new joiners when they started working live with tools .
- Worked on different Proovider Tax Identification Number (TIN) .
- Website finding (commercial payor) for business profit and time saving .
- Managed system conversion and maintained minimal downtime during updates.
- Experienced in CMS-1500, cpt, procedure, modifier, deductable, co-ins, co-pay .
- Worked closely with payors like Medicare, Medicaid, Cigna, ChampVa, Blue Cross Blue Shield Of North Carolina, Kaiser Permanente, UnitedHealth Group, Aetna, Anthem, Humana, Liberty Mutual, Molina Healthcare and so on.
- Experienced in EOB, CMS-1500 and UB-04, deductable, co-insurance, co-pay, client project .
- Created spreadsheets using Microsoft Excel for daily, weekly and monthly reporting.
GOOGLEGurgaon, Haryana
Admin
01.2017 - 07.2017
Job overview
- Completed 2 months training and assessment for production .
- Worked for the YouTube process where needed to check content and quality of 80 videos on the daily basis.
- Experience in analyzing videos main tags Strike,Racy,Approve.
- Maintained quality while achieving the daily target.
Education
Jamia Hamdard University
BBA from Bachelor of Business Administration
07.2013 - 07.2016
Skills
Workforce management (WFM)
undefinedCertification
Level 1 CCDP Certification
Timeline
Senior Analyst
PrimEra Medical Technologies
12.2022 - Current
Six Sigma Black Belt: Certified QFD Specialist (Accredited)
12-2022
Sr. Executive Ar Calling
CODITECH SOFTWARE SOLUTIONS A Corrohealth Company
06.2022 - 08.2022
Process Associate
Tata Consultancy Services
03.2021 - 01.2022
Digital Marketing
03-2021
Level 1 CCDP Certification
07-2019
Senior Analyst
R1RCM Global Pvt.Ltd
02.2019 - 02.2021
Admin
GOOGLE
01.2017 - 07.2017
Intermediate certificate for German language
10-2016
Jamia Hamdard University
BBA from Bachelor of Business Administration
07.2013 - 07.2016
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