Vishnushree V
Palani
Summary
Results-driven and detail-oriented Accounts Receivable (AR) Caller with [5 years and 6months] of experience in the US healthcare and medical billing industry. Skilled in insurance follow-up, claims resolution, and denial management to ensure timely reimbursement and coordinating with insurance companies to resolve outstanding claims. Adapt at meeting productivity benchmarks and quality standards while maintaining compliance with HIPAA regulations. Proven ability to communicate effectively, work in fast-paced environments, and contribute to process improvement initiatives.
Overview
8
8
years of professional experience
Work History
Claims Specialist
Med-metrix
Chennai
12.2024 - Current
- Managing end-to-end denial management for healthcare claims
- Utilizing websites and telephonic communication to resolve denials
- Corresponding with payers for claims resolution
- Processed healthcare claims from submission to resolution, ensuring adherence to policies and guidelines.
- Conducted thorough investigations on denied claims, utilizing policy resources and documentation.
Senior Client Partner
Allysmart
Chennai
07.2022 - 04.2024
- Made outbound calls for various insurance types, ensured resolution of claims
- Specialized in Dental client accounts and insurance processes
- Proficient in EPIC software and dental insurance website navigation
- Submitted appeals for denied claims as needed and followed up on status updates from payers.
- Processed insurance claims and submitted them electronically to the appropriate payer.
Client Partner
Ags Healthcare
11.2020 - 09.2021
- Maintained robust communication with payers via phone and website for claims follow-up
- Prioritized high-dollar and aged claim expedited resolution and posted adjustments
Junior Account Executive
Miramed Ajuba
Chennai
10.2017 - 10.2019
- Investigated and resolved claim denials using call and website processes
- Proficient in EPIC and modmed software
- Called delinquent accounts to collect past due balances.
- Contacted insurance companies to check status of claim payments.
- Wrote appeal letters to insurance companies for denial of claims.
Education
PRG MATRIC HR.SEC. - Secondary Schooling
PRG MATRIC HR.SEC. SCHOOL
B.E - Electronics & Communication Engineering
JANSONS INSTITUTE OF TECHNOLOGY
Skills
- Denial Management
- Client Communication
- Medical & Dental Insurance Expertise
- Correspondence Handling
- Analytical Skills
- Problem-Solving Skills
- Claims Investigation
- Claims Resolution
- Data Accuracy
Disclaimer
I, Vishnushree, hereby declare that the information given above is true and correct to the best of knowledge.
Timeline
Claims Specialist
Med-metrix
12.2024 - Current
Senior Client Partner
Allysmart
07.2022 - 04.2024
Client Partner
Ags Healthcare
11.2020 - 09.2021
Junior Account Executive
Miramed Ajuba
10.2017 - 10.2019
PRG MATRIC HR.SEC. - Secondary Schooling
PRG MATRIC HR.SEC. SCHOOL
B.E - Electronics & Communication Engineering
JANSONS INSTITUTE OF TECHNOLOGY