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, India01.2022
B.com - Commerce
Prince Shri Venkateswara Arts And Science College
Chennai, India01.2019
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