Sujitha G
Coimbatore
Summary
Dedicated process executive successful at helping customers resolve problems, organizing applications and submitting paperwork. Good communicator and multitasker with a well-coordinated and thorough approach.
Overview
5
5
years of professional experience
Work History
Process Executive
Velan Info tech
Coimbatore
08.2022 - Current
- Execute planning of deliverables and responsible for performing RCM process, starting from Payment Posting, Denial Management, and AR Management.
identifying issues and solving them thru root cause analysis. - My role involves process management and interaction with our US office for all planning and process improvements to achieve and exceed the client SLAs while maintaining organizational standards and processes.
- Should work towards client satisfaction and employee satisfaction, and will take the responsibility of keeping the team size intact.
- Review capacity utilization across each project against deliverables. Actively drive and monitor the daily production, quality, and deliverables.
- Receive and review payment documents, including explanation of benefits (EOBS), remittance advices.
Enter payment information into healthcare organizations' billing and accounting systems. - Ensure that payments are posted accurately, including the allocation of payments to the correct services, procedures, and accounts.
- Identify and resolve any discrepancies, such as underpayments, overpayments, or denials.
Identify any discrepancies and escalate issues to the appropriate personnel for resolution.
Adhere to healthcare industry regulations, such as HIPAA, and ensure that payment posting processes comply with established policies and procedures.
To make sure that all the deliverables adhere to the quality standards.
Wipro Associate
wipro
Coimbatore
05.2021 - 08.2022
- Developed and maintained relationships with clients and vendors.
- Ensured compliance with company safety regulations at all times while on the job.
- Follow up with the payer to check on claim status.
Identify denial reason and work on resolution.
Save claim from getting written off by timely following up. - Initiate calls to insurance companies for claim resolution and follow up.
- Transfer the outstanding balance to the patient of he/she doesn’t have adequate insurance coverage.
- If the claim has already been paid, ask the insurance company for an EOB. Make corrections to the claim based on inputs from the insurance company.
- Processed requests for additional documentation from customers in a timely manner.
- Participated in training sessions conducted by insurers on new products and services.
- Reviewed customer insurance claims to ensure accuracy and completeness of information.
System Analyst
Cognizant Technology solutions
Coimbatore
09.2019 - 03.2020
- Maintained up-to-date knowledge about technology developments related to the organization's business processes.
- Provide exceptional service to our clients. Serve as the first point of contact for clients through our helpdesk, be that via phone, email, or ticket.
- Provide our clients with basic remote and as needed, onsite, IT maintenance and monitoring support Use our Professional Services Automation (PSA) software, Autotask, to work on and resolve helpdesk tickets and service requests
- Manage and record all work through our ticketing system. Communicate to the client the status of their ticket or project on a regular basis (as outlined in our Client Experience and Staff Expectations Policy), notify them of any changes or possible interruptions to workflow related to their issue
- Provided user support on a variety of technical issues related to system operations.
- Created and updated user accounts in accordance with organizational policies.
Education
Bachelor of Science - Computer Technology
Sri Krishna Arts And Science
Coimbatore04-2019
High School Diploma -
GRG
Coimbatore03-2016
Skills
- Operations Management
- Claims Processing
- Coaching and Mentoring
- Workflow Analysis
- Document Preparation
- Insurance knowledge
- Allocating claims
- Verbal Communication
- Teamwork and Collaboration
- Microsoft Office
- Data Entry
- Client Interviews
- Organizational Skills
- Self Motivation
- Excellent Communication
- Problem-Solving
- Multitasking
- Time management abilities
- Team building
Languages
Tamil
First Language
English
Advanced (C1)
C1
telugu
Intermediate (B1)
B1
Timeline
Process Executive
Velan Info tech
08.2022 - Current
Wipro Associate
wipro
05.2021 - 08.2022
System Analyst
Cognizant Technology solutions
09.2019 - 03.2020
Bachelor of Science - Computer Technology
Sri Krishna Arts And Science
High School Diploma -
GRG
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