Shalini Rajendran
Summary
To pursue a challenging and fulfilling career that would aid in my personal and professional growth. Willingness to engross the responsibilities given, work towards the mission and vision of the company with commitment and integrity to accomplish the goal as an individual and also as a part of the team.
Overview
16
16
years of professional experience
Work History
Senior Reimbursement Specialist
Revele Technologies
06.2014 - 07.2023
- Attending client meetings, Presenting AR analysis reports, Denial Reports, weekly submitted charges reports and collection reports on weekly and monthly basis.
- Creating & implementing workflows to facilitate structured support in all areas and issues.
- Monitoring the overall functioning of processes, identifying improvement areas and implementing adequate measures to maximize client satisfaction level.
- Work allocation to team members depending on priority and ensure it is being completed within TAT.
- Managing the revenue of clients, verifying dashboard and review insurance & patient aging and also keeping a keen watch on AR action response for cases raised by the customer.
- Monitoring the performance of the team members and giving them timely feedback on the areas of improvement.
- Replying emails on time on provider side clarifications.
- Tracking Insurance & patient payments on time.
- Conveying the client requirement to the team and ensure the teams meets the client satisfaction and targets on time.
- Working on electronic rejections on daily basis, fix them and resubmit them on timely manner to avoid untimely filing denials.
- Sound knowledge of U.S. Healthcare Domain (Provider side)
- Working on Denials, Rejections, Request for Additional Information
- Maintain a spreadsheet by practice of claims sent for review / appeal with follow-up dates and tracking details
- Meet weekly with Client to discuss the status of accounts sent for review and to report reoccurring denial exceptions.
- Other billing related tasks as needed, requested by the team Managers.
Senior AR Analyst
AGS Health PVT.Ltd
11.2012 - 05.2014
- Calling Insurance Companies For Claim Follow-up, identify issue with claim based on information provided by insurance Companies
- Convince the claims company for payment of their outstanding claims
- Analyze medical claims and resolve issues
- Sound knowledge of U.S. Healthcare Domain (Provider side)
- Knowledge of the entire Revenue Cycle Management (RCM).
- Working on Denials, Rejection, Request for Additional Information
- Knowledge on Referrals and Authorization
- Patient Calling and Client correspondence
- Experience using software tools (EPIC & ALLEGRA) for claim Management
- Responsible for collection activities on charged off debt portfolios
- Worked in an outbound calling environment to locate and work with consumers to resolve their charged off debt
- Meeting work metrics of daily number of accounts worked and promises taken and monthly collection targets
- Initiate telephone calls to insurance companies requesting status of claims in queue and for further explanation of denials and underpayments
- Review denials with Billing Account Liaison to determine necessary steps for claim review. Document actions taken in claims billing summary notes
- Maintain a spreadsheet by practice of claims sent for review / appeal with follow-up dates and tracking details
- Post billing notes for the AR team in the claim summary
- Meet weekly with Billing Account Liaisons to discuss the status of accounts sent for review and to report reoccurring denial exceptions.
- Other billing related tasks as needed, requested by the team lead
Credit & Collections Sr Representative
Dell International Services
08.2009 - 06.2012
- Claim Management using the software MEDISOFT, IMS & E-CLINICAL
- Calling Insurance Companies For Claim Follow-up, identify issue with claim based on information provided by insurance Companies
- Convince the claims company for payment of their outstanding claims; Analyze medical claims and resolve issues
- Meeting work metrics of daily number of accounts worked and promises taken and monthly collection targets
- Contact insurance companies for further explanation of denials and underpayments
Senior Customer Service Executive
Altech Star BPO
09.2007 - 07.2009
- Market Knowledge about all Gas & Electricity service providers in the United Kingdom.
- Understanding the requirement of the client & provision of a suitable alternate/service as the case may be, comparison of the existing & suggesting services to give a better overview for the services used by the client.
- Cater to a range of client requirements with very wide service expectations.
- Adhere deadlines & commitments to the client & to the company.
- Co-operative responsibility as a team to meet the desired targets.
- Ability to converse in the regional language of the client for better reach & convince for a better energy solution. Responded to customer inquiries and queries to provide thorough and speedy resolutions.
- Answered multi-line phones and used active listening skills to assess client's issues and challenges.
Education
Bachelor of Science - Microbiology
Kendriya Vidhyalaya CRPF
Chennai04.2007
Skills
- Hard working and Persistent
- Dedicated and ability to grasp any new learning precisely
- A go-getter with set mental targets
- Ability to work efficiently under pressure
- Good fluency in English and typing skills
- Audit Support
- Billing Review
- Information Updates
IT KNOWLEDGE:
- Operating Systems : Win 98//2000/XP/7 Programming Language : MS Office & Excel
Accomplishments
AWARDS & RECOGNITIONS:
- Awarded Luminary of the quarter from client “The Christ Hospital” from Dell services.
- Best performer award & client appreciation from AGS health.
- Best performer by Revele Technologies.
Languages
English
Professional Working
Hindi
Full Professional
Tamil
Native or Bilingual
Telugu
Native or Bilingual
Malayalam
Limited Working
Timeline
Senior Reimbursement Specialist
Revele Technologies
06.2014 - 07.2023
Senior AR Analyst
AGS Health PVT.Ltd
11.2012 - 05.2014
Credit & Collections Sr Representative
Dell International Services
08.2009 - 06.2012
Senior Customer Service Executive
Altech Star BPO
09.2007 - 07.2009
Bachelor of Science - Microbiology
Kendriya Vidhyalaya CRPF
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