SURAJ BISHT
Appeal Claim Processor
New Delhi
Summary
Appeal Advocate analyzes healthcare appeals for insurance claims, reviews medical documentation, and resolves denied claims through direct follow-up with insurers. Maintains accurate appeal records and uses MS Excel and MS Word to track case status and outcomes. Coordinates with internal teams to close claim issues and keep cases moving.
Overview
1
1
Language
5
5
years of professional experience
Work History
Appeal Advocate
Concentrix
- Analyse and processed healthcare appeals for insurance claims.
- Reviewed medical documentation and determined the eligibility of appeals.
- Handled denied claims and worked on resolution by interacting with insurance providers.
- Maintained accurate records of appeals and resolutions.
- Communicated effectively with internal teams to resolve claim issues.
- Utilized MS Excel and MS Word for reporting and tracking appeal statuses.
- Access healthcare | Healthcare Process
- Duration: 2 Years
Medical Representative
Zyduss Welness
01.2023 - 02.2024
- Developed and maintained relationships with healthcare professionals to promote product awareness.
- Conducted product presentations and demonstrations to educate clients on product benefits.
- Collaborated with sales teams to strategize and implement marketing initiatives effectively.
- Monitored market trends and competitor activities to identify growth opportunities.
- Provided accurate product information and support to healthcare providers in a timely manner.
- Assisted in organizing promotional events, enhancing brand visibility within the medical community.
- Engaged in continuous learning about new products and industry regulations for compliance purposes.
- Established strong relationships with healthcare professionals, resulting in increased trust and credibility for the organization.
- Assisted physicians with patient education efforts, providing resources and support as needed.
- Collaborated with sales team to develop targeted marketing strategies that boosted overall revenue growth.
- Regularly exceeded sales targets by establishing rapport with new clients while maintaining long-lasting relationships with existing ones.
- Recognized trends within territory and industry to create proactive plans.
- Improved product knowledge for team members through regular training sessions and workshops.
Accounts Assistant
Sana-Di-Ge
08.2019 - 10.2021
- Processed invoices and expense reports, ensuring accuracy and compliance with company policies.
- Assisted in maintaining financial records using accounting software, enhancing data integrity and accessibility.
- Supported account reconciliations, identifying discrepancies and collaborating with team members to resolve issues.
- Prepared monthly financial statements, contributing to informed decision-making for management reviews.
- Maintained clean and organized files by keeping accounts payable records up-to-date.
- Performed administrative and clerical duties such as word processing, data entry, faxing and copying.
- Processed payments and documents such as invoices, journal vouchers, employee reimbursements, and statements.
- Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
- Communicated and resolved disputes with clients regarding outstanding invoices, payments and adjustments.
- Supported the accounting team with month-end closing procedures, ensuring timely completion and accurate reporting.
- Streamlined invoice processing for improved efficiency and timely payments to vendors.
- Processed credit card payments and reconciled credit card statements for accuracy in accounting process.
- Recorded deposits, reconciled monthly bank accounts and tracked expenses.
- Matched purchase orders with invoices and recorded necessary information.
- Handled day-to-day accounting processes to drive financial accuracy.
Education
B.A. - English
Sridev Suman Garhwal University
01-2019
Senior Secondary (12th) - undefined
U.K Board
01-2013
High School (10th) - undefined
U.K Board
01-2011
Skills
Claims review and resolution
Research and documentation of denials
Healthcare insurance processes
Microsoft Excel and Microsoft Word proficiency
Healthcare appeals analysis
Denial management
Appeal case tracking
Medical documentation review
Claims status reporting
Insurance provider communication
Prior authorization
Medical billing software
ICD-10 coding
CPT coding
HIPAA compliance
Root cause analysis
Quality assurance auditing
Interests
Interests & Hobbies: Listening to music and drawing
ADDITIONAL ACHIEVEMENTS
Awarded trophies and medals for academic and extracurricular excellence in school.
DECLARATION
I hereby declare that the above information is true and correct to the best of my knowledge and belief.
Timeline
Medical Representative
Zyduss Welness
01.2023 - 02.2024
Accounts Assistant
Sana-Di-Ge
08.2019 - 10.2021
High School (10th) - undefined
U.K Board
Senior Secondary (12th) - undefined
U.K Board
B.A. - English
Sridev Suman Garhwal University
Appeal Advocate
Concentrix