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Quality Assurance Medical Claims

Location:
Carson, CA
Posted:
January 24, 2024

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Resume:

SHUBHRA

BHARDWAJ

Address:

***** * ****** ****, ***** South Bay

Apartment # 407 B Carson, CA 90745

Phone:

+1-424-***-****

Email:

ad22ze@r.postjobfree.com

Summary

Medical Professional (Bachelor of Homoeopathic Medicine and Surgery) ulitizing extensive knowledge in Claim Auditing and Medical Coding with strong attention to details and juggles multiple tasks. Committed to handling claims expeditiously. Excellent skills compiling, coding, categorizing, and auditing information to process claims.

Skill Highlights

• Certified Claim Professional

• Fraudulent claim Investigator

• Medical Terminology

• Continuous learning

• Medical Professional

• Software Proficiency

• Review Of Medical Records

• HIPPA Complience Understanding

• Quality Assurance

• Critical Thinking

Experience

OPTUM - May 2016 – November 2022

• Examine claim by conducting thorough investigations and research, and resolved complex medical claims issues with the expertice in medicine to support timely processing.

• Identified fraudulent activities by analysing patterns, trends, and discrepancies in medical claims data. ( First review, Second review and Appeals )

• Played the role of knowlege expert, by mentoring, guiding and assuring quality control of new hirers.

Worked with cancer healer center as an assistant doctor in 2015. Private Practice of Homeopathic Medicine - 2011-2015. Good knowledge of clinical examination, diagnosis, and medicines - Gynecological, Dermatological and Pediatrics patients.

Education

Bachelor of Homoeopathic Medicine and Surgery: 2005 -2011 Guru Govind Singh Indraprastha university

Internship Project - The efficacy of Homoeopathic medicines in the treatment of menopausal Syndrome Certifications

CPC (Certified Professional Coder) - 2023 - AAPC - 88%



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