Sujan D

• Manage end-to-end payroll processing and maintenance, ensuring accurate and timely payment distribution for diverse client groups.
• Implement rigorous data validation and audit procedures to minimize payroll discrepancies and maintain high data integrity.
• Calculate and process employee tax withholdings, ensuring adherence to local, state, and federal tax regulations.
• Maintain comprehensive employee records, including onboarding, terminations, compensation changes, and benefits updates.
• Administer employee benefits such as health insurance, retirement plans, and additional perks, ensuring accurate enrollment and timely updates.
• Address and resolve client inquiries related to HR policies, onboarding processes, benefits enrollment, and payroll adjustments.
• Serve as a trainer and mentor for new hires, successfully training three batches on compliance, process excellence, and operational standards.
• Lead focus groups for low-performing employees by providing targeted coaching, performance-improvement strategies, and compliance reminders.

ACA Compliance & Reporting Responsibilities:

• Serve as an internal Subject Matter Expert (SME) for ACA regulations, IRS filing requirements, and compliance procedures.
• Manage end-to-end ACA compliance reporting, including preparation and filing of 1094-C/1095-C forms.
• Perform ACA data audits to identify discrepancies in payroll, benefit offerings, eligibility, and ESRP requirements.
• Conduct ALE determination, affordability safe harbor calculations, and validation of ACA codes.
• Reconcile payroll and benefits data to ensure accuracy before IRS submissions.
• Identify potential penalty exposures, recommend corrective actions, and develop compliance documentation, SOPs, and audit guidelines

• Processed manual insurance payments, electronic remittances, and patient financial transactions.
• Accurately posted all patient and insurance adjustments and maintained up-to-date records.
• Resolved denials and EOB rejections within standard billing cycle timelines.
• Investigated and reconciled Paid Not Posted (PNP) issues to maintain financial accuracy.
• Collaborated with internal departments to streamline revenue processes and improve posting accuracy.
• Specialized in working with Overpaid/Underpaid claims and executing appropriate follow up action.
• Processed, adjudicated and clarified claims queries for insurance providers regarding the various claims scenarios such as denial, rejections and pricing adjustment.

• Processed and adjudicated health insurance claims, including pricing adjustments and denial management.
• Handled medical records review, claim benefits verification, and patient eligibility validation.
• Monitored authorization requirements for procedures and services, ensuring compliance with policy guidelines.
• Resolved claim-related queries from providers (doctors), payers, and internal teams.
• Managed claim rejections, performed corrections, and ensured accurate documentation for processing.
• Contributed to improving claim turnaround times by ensuring precision in claim analysis and documentation.