SIVA PRIYA D,

Mobile No : 996-***-****

Email Id : adlwn9@r.postjobfree.com

CAREER OBJECTIVE

To obtain a position that will enable me to use my talent and skill and simultaneously gain knowledge under the expertise of the organization.

EXPERIENCE :

Processor(Analyst) in Source HOV Pvt Ltd.,Chennai. Experience in Health care Adjudication process (AUGUST 2017 – JULY 2019)

Senior Process Executive in Omega Healthcare., Chennai .

(SEPTEMBER 2019 – JULY2020)

EDUCATIONAL QUALIFICATION

B.Sc.(Advanced Zoology and Biotechnology) (2017) – 72%

JBAS College for Women, Chennai.

Higher Secondary (2014) – 63%

St.George.Mat.Higher Secondary School,

Chennai.

SSLC (2012) – 82%

St.George.Mat.Higher Secondary School,

Chennai.

ROLES & RESPONSIBILITIES :

Source HOV Pvt Ltd - (AUG2017- JUL2019)

Project :BCBSNC (Blue Cross Blue Shield of North California)

Account Receivable processing to validate the Medical Claims

Refund the payment for Provider or Subscriber.

Maintained records of claims accepted, denied and adjudication decisions

Drafting and mailing denial and acceptance letter for claims submitted to clients

Handled Software: Amisys for Claim Processing and Macess for work flow, Pristine for EDI claims to view image. Hcfa 1500 and Ub-04 Images.

Omega Healthcare - (SEP2019- JUL2020)

Liberty HealthShare – (Gospel light Mennonite Church)

Managed claim system and provided information to new member.

Evaluated referrals and provided authorization for claims.

Update the member CPT (Current Procedural Terminology) and ICD (International Classification of Diseases).

Change Healthcare – Radiology

Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in medical records.

Modifiers added to CPT codes when they are required to more accurately describe a procedure performed or service rendered.

Handled Software: 3M CodeRyte for coding and EncoderPro for searching codes.

POSITIVE TRAITS :

Problem solving, Good Communication, Flexible, Adaptable, Self-Motivator and Self Learner.

PERSONAL INFORMATION

Father’s Name : A.Dasarathan

Date of Birth : 17.09.1996

Sex : Female

Languages Known : English, Tamil.

Address : No:12, LGGS colony

22nd street, Ashok Nagar

Chennai – 600083.

DECLARATION:

I hereby declare that the above particulars are true and correct to the best of my knowledge and belief.

Place : Chennai

Date : (SIVA PRIYA. D)

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