Summary
Overview
Work History
Education
Skills
ACHIEVEMENTS
Certification
LANGUAGE
Timeline
Generic

Venkatesh G

Chennai

Summary

Obtaining a challenging position by applying creative problem solving and learning management skills and gain further experience while enhancing the company’s productivity
and reputation.

Overview

3
3
years of professional experience
1
1
Certification

Work History

Process Executive

Access Health care
09.2024 - Current
  • Reviewed claim denials and payer requirements for corrective action and prevention in future
  • Maintained and departure of clinical records with respective cases and in a timely manner.
  • Followed up with insurance companies to resolve pending and denied claims.
  • Handled claim status checks, appeals, and payment-related queries with accuracy.
  • Analyzed aging reports and ensured timely collection of outstanding payments.
  • Identified root causes of denials and implemented corrective actions.
  • Skilled at working independently and collaboratively in a team environment.

Process Executive

Omega Health care
11.2022 - 10.2023
  • Worked in end to end process, which is the last source of payment to providers
  • Processing through Fax ,Mail and Portal
  • Reviewing Medical records and other valid treatment proofs.
  • Executed the clearing of front-end rejection of claims and appealed the claims towards resolution.
  • Reviewed claim denials and payer requirements for corrective action and prevention in future
  • Maintained and departure of clinical records with respective cases and in a timely manner.
  • Assisted with day-to-day operations, working efficiently and productively with all team members.

Education

M.com - Commerce

Prince Shri Venkateswara Arts And Science College
Chennai, India
01.2022

B.com - Commerce

Prince Shri Venkateswara Arts And Science College
Chennai, India
01.2019

Skills

  • Expertise in insurance follow-up and claim status verification
  • Understanding of EOBs (Explanation of Benefits) and denial
  • Claim status check and appeal follow-ups
  • Experience with provider portals (eg, Availity,UHC)
  • leadership and time management skills
  • Exceptional communication and interpersonal skills
  • Detail oriented and able to handle multiple tasks simultaneously
  • Effective in managing and supporting team operations
  • Proficiency in MS Word, MS Excel, Powerpoint

ACHIEVEMENTS

  • Received reward and recognition for team contributions.
  • Consistently achieved 100% quality score in call audits and documentation accuracy.
  • Maintained 100% compliance with HIPAA and client confidentiality standards.
  • Recognized as a Top Performer of the Month for exceeding daily call targets and maintaining call quality.
  • Ensured on-time closure of 95%+ pending claims, improving team productivity.

Certification

Tally Erp9

LANGUAGE

English
Tamil
Kannada

Timeline

Process Executive

Access Health care
09.2024 - Current

Process Executive

Omega Health care
11.2022 - 10.2023

M.com - Commerce

Prince Shri Venkateswara Arts And Science College

B.com - Commerce

Prince Shri Venkateswara Arts And Science College
Venkatesh G