Venkatesh Pemala
Senior process associative
Tirupati
Summary
Achievements:
- Rock Star Pinnacle Award – Best Employee
Awarded for outstanding performance, excellence in customer service, and leadership within the team at AGS Healthcare. Recognized for consistently exceeding targets, improving workflows, and demonstrating exceptional problem-solving skills.
- Successfully reduced insurance authorization turnaround time by 30% by improving internal workflows.
- Played a key role in securing pre-authorization for over 500 procedures per month with a high approval rate.
- Developed a process to expedite urgent authorizations, ensuring no delays in patient care.
Overview
2
2
years of professional experience
1
1
Certification
Work History
Senior Process Associate
AGS Health
2022.10 - Current
- Verify patient insurance eligibility and benefits for medical services and procedures.
- Initiate and manage pre-authorization requests for surgeries, tests, and treatments.
- Collaborate with physicians, patients, and insurance companies to ensure timely approvals.
- Maintain accurate records of authorizations, rejections, and appeals within the company’s database.
- Resolve denied claims by working with healthcare providers and insurance companies to submit corrected documentation.
- Ensure compliance with HIPAA and other healthcare regulations.
- Provide administrative support by updating patient information and ensuring proper documentation of insurance policies.
Education
Master of Computer Applications - A Postgraduate Degree
Gate Institution of Technology - S.V Univeristy
Tirupati, India 2001.04 -
Bachelor of Computer Applications - Computer Applications Development
SDHR Degree College - S.V University
Tirupati, India 2001.04 -
Skills
In-depth knowledge of insurance verification and pre-authorization processes
Excellent communication skills with healthcare providers and insurance representatives
Ability to analyze and resolve claim denials and authorization issues
Proficient in EHR systems (Epic)
Strong organizational and time-management abilities
Certification
Rock star - Best Employee
Timeline
Rock star - Best Employee
2023-12
Senior Process Associate
AGS Health
2022.10 - Current
Master of Computer Applications - A Postgraduate Degree
Gate Institution of Technology - S.V Univeristy
2001.04 -
Bachelor of Computer Applications - Computer Applications Development
SDHR Degree College - S.V University
2001.04 -