Viraj Surve

*Examined and rectified claim denials utilizing Meditech software.

*Claim Auditing & Follow-ups: Conduct audits on accounts, identify billing discrepancies, and follow up with payers for claim reconsiderations.

*User Assistance & Training: Assist users in understanding denial trends, workflows, and best practices for claim resolution.

*Inventory & Workflow Management: Monitor and manage claim inventory to optimize workload distribution and ensure timely resolution.

*Payer Communication & Appeals: Collaborate with insurance companies to dispute incorrect denials and escalate appeals as necessary.

*Process Improvement: Identify inefficiencies in denial handling and contribute to streamlining processes for better productivity.

*Reporting & Documentation: Maintain detailed documentation of denial trends, payer responses, and resolution outcomes for performance tracking.

• Worked for All Speciality- Hospital Billing
• Claims Processing: Submitting claims to insurance companies promptly and accurately, ensuring compliance with billing regulations and standards.
• Follow-up: Proactively following up on unpaid claims and outstanding balances with insurance companies and patients.
• Denial Management: Investigating and appealing claim denials, ensuring maximum reimbursement for services rendered.
• Reporting: Generating and analyzing financial reports related to accounts receivable, identifying trends, and recommending strategies for improvement.
• Compliance: Adhering to HIPAA regulations and other relevant healthcare billing guidelines to ensure confidentiality and data security.
• Team Collaboration: Collaborating with other departments such as coding, billing, and revenue cycle management to streamline processes and improve revenue capture.

• Worked for Oncology - Physician Billing
• Follow up on pending claims
• Process claims and ensure collections are met
• Analyze the rejected/denied claims and understand the reasons of rejections/denial and reprocess the same for payment
• Ensure targeted collections are met on a daily/monthly basis.

• Handling query desk of overseas customers through mails & calls
• Handling queries of two products - Indialink & SWIFT specially of (NEFT, RTGS, IMPS, IFT's) transactions
• Follow-up with beneficiary bank for credit status, Recall / Amendments of transactions
• Preparing remittance reports.
• Followed-up on discrepancies to assist business partners in customer inquiry investigations.