Neeraj Tyagi

**** ****** *****

West Chester, OH

Phone: 513-***-****

Email: ad3krl@r.postjobfree.com

Career Objective

I aim to seek an enterprise management trainee position in a challenging work environment, where I can utilize my skills and knowledge for the overall growth of the enterprise and enrich my learning abilities and experience in the related field.

Skills and Competencies

● Knowledge and experience in varied fields of management (marketing/sales/operation/customer service)

● Possess technical proficiency and its application process

● Have good leadership skills and the ability to handle a team.

● A fluent communicator with strong interpersonal ability

● Prompt decision-maker with a flair of solving problems effectively

● Ability to work in a cross-functional workplace (in terms of the work associated and the resources involved)

● A self-driven individual with a strong analytical thinking capacity

● Medical Claims and Billing Specialist experience

● Computer skills

Experience

Ensemble Health Partners, Initial review Denial Specialist, 2019- present

● Used Epic, Cerner, Meditech, and E-Clinical Works

● Denied accounts in assigned work queue reports, or as requested

● Identified and researched the correct root cause of denial and resolved the account

● Reviewed all post-billed denials for medical necessity/ clinical and technical denial

● Collected data for appeal information based on denial

● Looked for denial trends and escalated as necessary

● Handled incoming and outgoing telephone calls with clinical departments and insurance companies

● Worked a high-dollar account through appeals that resulted in an outstanding payment of $711,136.58 Denial Specialist, 2011-2017, Hamilton, OH

● Worked using E-clinical works and Emdeon Clearinghouse

● Gained extensive knowledge of ICD-10 CPT 4 HCPCS and DRG billing

● Verified insurance

● Worked collaboratively with management to create and analyze tracking reports to evaluate trends Prepared batches for dates of service, post, and balance

● Input charges, payment, and adjustment to computerized system/manual records

● Communicated with the clinics to provide or obtain corrected or additional data

● Assisted with training materials and training staff members

● Made outbound phone calls to resolve denial issues.

● Submitted bills for reimbursement to commercial insurance, Medicaid, and Medicare

● Organized and processed medical records

● Worked with unpaid insurance payments

● Maintained patient confidentiality

Subway, 2009-2011, Fairfield, OH

● Trained new employees

● In charge of keeping co-workers on task

● Made group decisions

● Provided excellent customer service

● In charge of balancing drawer

● Took inventory every shift

● Made reports

Education

● Bachelor's Degree in Commerce (Business)

● Master’s Degree in Commerce (Business)

● One-year certification in computing

● CRCR certification

Reference: On request.

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