Phanindar Yadav Golla

*** ***** ***,

North Bergen, NJ, 07047, USA

gollaphanindaryadav@gmail.

com

201-***-****

North Bergen

Skills:

Certified SQL, Certified Data

Analyst

Knowledge in Tableau,

Power BI

Microsoft excel, word, power

point presentation

NAMMS Credentialing

Specialist

Professional Summary: Highly adaptable and experienced healthcare management professional with background in administration of a rapidly growing, changing healthcare environment. Experienced in most widely used computer software, cloud programs, databases, healthcare terminologies and documents processing.

Work History:

Assistant Manager – Credentialing

Erankey IT Services Mar / 2021 - Dec / 2022 Vizag, India

We have worked for the client name BEST (Behavioral Education Service Team), verified and conducted

background investigation, research and primary source, providers work history, licensure, certifications, hospital affiliations, claims history and peer evaluations.

Ensured that all initial applications are filled and submitted on time and follow up with payer for every 14 days until we receive the welcome letter as in-network provider.

I have handled the team of 5 people. I used to audit their applications and allocating the work to team members. Subject Matter Expert - SME - Credentialing

PriMedical Solutions Pvt Ltd Mar / 2019 - Mar / 2021 Hyderabad, India

I have worked for the client (Siouxland Hospitalist PLLC) Hospital credentialing and enrolled all the providers in the hospital. I used to interact with doctors to collect the documents and sing on the filled applications.

Completed applications, applied for and assisted with the facilitation of obtaining hospital privileges for all new hospitalists joining IPC, which included reaching out to training institutions, hospitals, and references for responses to hospital inquiries in support of JCAHO requirements.

Worked CMS 855I and 855R, 855B, and CMS 460

applications and applied for TPIs for Medicaid privileging for all hospitalists (new and currently employed). Achievements:

Received best employee

award while working for the

client BEST (Behavioral

Education Services Team) at

Erankey IT services.

Published a research journal

on “Design and development

of automatic electronic

voting system using a

smartcard” in a national

conference at JBREC.

Highlights:

I have experience in Medical

and Dental billing and

coding, AR follow up

I have worked on EPIC

software to store provider

information.

Work History:

Senior Credentialing

MedConverge Pvt Ltd Dec / 2017 - Mar / 2019

Hyderabad, India

Interacting with doctors to gather demographics and documents to initiate the credentialing

Follow up with health insurance to check on the application status.

Worked for both Commercial and Federal Health

insurances.

Credentialing Specialist

Advantum Health Pvt Ltd Jan / 2017 - Dec / 2017

Hyderabad, India

Worked on provider CAQH and PECOS applications.

Worked on Medicare and Medicaid applications.

Hands on experience in EDI and ERA enrollments.

I have worked on payer credentialing projects with Aetna. Education:

St. Francis College, NY, USA

Graduation Degree: MS in Healthcare Management

Sept 2023 – Ongoing

Jawaharlal Nehru Technological University Hyderabad, India Under Graduation Degree: ECE

Sep 2012 – May 2016

Contact this candidate