Team Leader Insurance Verification

Manikandan V E

Tamil Nadu, INDIA

+91-904*******& +91-861******* *************@*****.***

Profile:

A reliable and experienced Team Leader with 3 years of experience, providing timely responses to emails, voicemails and written correspondence. Proven ability to troubleshoot complex administrative and training issues quickly and efficiently.

Demonstrated success in completing monthly physical inventory counts.

Educational details:

B.E., Electrical and Electronics Engineering (2010-2014) with 80%

H.S.C (2010) with 75%

S.S.L.C (2008) with 87%

Skills:

•Billing Knowledge

•Denials Management

•Insurance Verification

•Payment Posting

•AR Calling

•Claim Adjudication

•Strong Communication

•Problem Solving

•Team Handling

Career Development:

VEE Healthtek 28-03-2024 to Present

Vee Healthtek provides cutting-edge solutions that transform healthcare organizations. As a trusted partner to top medical institutions and payers, we offer a comprehensive suite of services that leverages our industry expertise and results-driven mind set to provide the best possible value to our clients.

Designation: Senior AR caller

Call Insurance companies on behalf of physicians and carryout further examination on outstanding Accounts Receivables.

Prioritize unpaid claims for calling according to the length of time it has been outstanding.

Evaluate unpaid insurance claims.

Call insurance companies and check on the status of claims.

Transfer the outstanding balance to the patient of he/she doesn’t have adequate insurance coverage.

Bass Enterprises Data Solutions Private Ltd (formerly Orchestrate HR) 05-07-2018 to 15-03-2024

Bass Enterprises has created an enterprise level Human Resource Management System (HRMS) consisting of a single architecture, Oracle database. This HRMS technology allows a small business to access the technology solutions of larger corporations at a lower cost point than a technology purchase (i.e., cloud computing). Our HRMS platform is designed to eliminate the need to manage multiple HR vendors and systems and manage the entire employee life cycle in a single application with our vendor

Designation: Lead Associate- AR Collections (Duration: 3 Years)

Roles and Responsibilities:

•Completed physical inventory counts each month.

•Established as reliable resource for team members troubleshooting complex administrative and training issues promptly.

•Initiated timely response to emails, voicemails and written correspondence.

•Call Insurance companies on behalf of physicians and carryout further examination on outstanding Accounts Receivables.

•Prioritize unpaid claims for calling according to the length of time it has been outstanding.

•Evaluate unpaid insurance claims.

•Call insurance companies and check on the status of claims.

•Transfer the outstanding balance to the patient of he/she doesn’t have adequate insurance coverage.

Designation: Senior Associate- Claims Adjudication (Duration: 2 Year) Roles and Responsibilities:

•Process Adjudication claims and resolve for payment and denial.

•Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process.

•Knowledge in concept of in-network, out of network, Deductible, Copay and Coinsurance.

Previous Career Development:

Source HOV India Private Ltd 11-01-2016 to 30-11-2017

Source HOV is a global Transaction Processing Services (TPS) and Enterprise information Management (EIM) leader. Source HOV provides services and solutions for high-volume, mission-critical organizations seeking to drive efficiency with their business processes. They deliver innovative end to end solutions, incorporating data capture, aggregation, data analytics and outcome resolutions.

Designation: Processor

Projects Worked:

Nice Adjudication

Role: Data Load Analyst Duration: Sep-2017 to Nov-2017

Roles and Responsibilities:

Supported for Claims processing and Payment posting

a.Developed the entire data analysis rule using information of US providers claiming bill.

b.Profiling the entire data and the report is generated based on their benefits.

c.Identifying and collecting data of providers based on their claims posting.

d.Adjudicating the Payment based on UHG policy and their terms.

PCDM (Provider Contract Data Management)

Role: Data Load Analyst

Duration: Jan-2016 to Aug-2017

Roles and Responsibilities:

Supported for Claims processing and claims adjudicating

a.Analysis of US providers by using information from NICE platform and CSP facets.

b.Claims checked from NICE platform and facets are used to analyze the data

c.Identifying the entire data of US providers and rectify the errors.

d.Clarifying the error records by raising the tickets to central team using Outlook.

Cab India Private Ltd 03-01-2015 to 05-01-2016

Designation: Customer Care Executive

Roles and Responsibilities:

Supported for Customers taxi booking and handling drivers

a.Handling Phone Calls from Customers and booking the taxi.

b.Generate feedbacks from customers experience while travelling.

c.Handling driver phone calls and reach them to customers place.

Personal Details:

Father name : V K Eswaran

Date of Birth

: 08-june-1993

Gender

: Male

Marital Status

: Married

Languages

: Tamil, English

DECLARATION:

I have furnished the entire details about my work experience and academic career which is true to my knowledge. I assure you that I will do my best to your company on entry.

Date: Yours faithfully

Manikandan V E

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