Assurance Auditor Revenue Manager
Resume:
Dinesh Kamble
https://europa.eu/!wg**rk
At, Plot no. 28 Bawane-layout,
Dwarka nagar, Shrirampur District:
Yavatmal, State Maharashtra,
445204 City Pusad (India)
Passport No.: T5463244
adnfvy@r.postjobfree.com
Whatsapp Messenger: +919*********
www.linkedin.com/in/dinesh-kamble-4269a63a
Subject: With Reference to job opening.
To,
The Recruitment Division
Dear Ma’am/Sir,
Through this letter, I want to introduce myself and to show my interest in becoming part of your organization. I have attached below 02 pages of my resume which consists of my detailed experiences such as employment background, training experiences, achievements, education and skills. My work experiences are strengthened with high responsibility and efforts. I would bring my skill- sets to work for your organization.
I have successfully performed my tasks with high degree of professionalism. My previous employer felt satisfied with my efforts in previous work. My current objective is to obtain a position that will expand my skills and experiences properly.
I believe in excellence and have always dedicated myself, my talents and creative abilities to assure the successful accomplishment of any company goals. My positive and hard-working attitude is the valuable asset to any organization that would employ me. I am certain that my skill-set will bring profit to your company.
I look forward to hearing from you in the near future and hopefully to schedule an interview. Please feel free to contact me at your earliest convenience.
Thank you,
Yours faithfully,
Mr. Dinesh Kamble.
Dinesh Kamble
DATE OF BIRTH: 10 Oct 1984
MARITAL STATUS: Unmarried
NATIONALITY: Indian
GENDER: Male
CONTACT:
https://europa.eu/!wg39rk
Address: At, Plot no. 28
Bawane-layout, Dwarka
nagar,, Shrirampur, District
Yavatmal, State Maharashtra
445204 City: Pusad, India
E-mail:
adnfvy@r.postjobfree.com
Phone numbers:
DIGITAL SKILLS:
Microsoft Excel / Outlook /
Microsoft Office / Zoom /
Effective interpersonal
communication and delivering a
good oral presentation. / Quality
Management System (QMS) /
team management and leadership
/ Healthcare Data Management /
Excellent Client Interactions
Skills / Information
Management, Data Analytics /
Report Preparation / problems
solving.
WORK EXPERIENCE
15 FEB 2021 – CURRENT – Vadodara, Gujrat, India
Call center quality assurance auditor (Quality Analyst) Insync Technologies, IHCS healthcare
Appointed as an Auditor, auditing 49 mental health doctors client's work for charges, Account Receivables & denied claims, Working on billing software
(Electronic Health Record): Client interactions / calls, team meetings, team handling, taking care of Service Level Agreement & Key Result Areas, Daily Production & Quality Tracker, working on Billing & Practice specific guidelines. Working on Defect per Opportunity and Defect per Unit. Strictly obeying HIPAA act 1996 and Compliance.
20 FEB 2017 – 3 FEB 2021 – Mumbai, India
Call center quality assurance auditor (Quality Analyst) GeBBS Healthcare Solutions, Pvt Ltd
Appointed as an Auditor, auditing Client's work, working on billing software
(Electronic Health Record): Meditech magic, 10e of eClinical works, Cerner CPM/ RCI, PowerChart, NThrive, Revenue Manager, Trizetto Provider Solutions, Emdeon etc. Microsoft Excel & PowerPoint. Auditing for processes: Xtend Healthcare LLC, Cerner Corporation, etc. Particular emphasis on revenue generation (these are a soft-core collection processes. Claim processors (billers) have to work on the patient's account unless the balance gets zeroed out). Preparing update tracker, briefing updates, updating daily Quality and Training. Extracting, preparing reports from client's software, allocating them, Preparing daily reports & Dashboard weekly, monthly, analysis of quality percentage & error types, error percentage & preparing Error Pareto, Bottom Quartile Management. Biller wise root cause analysis (RCA), feedback & coaching. Strictly obeying HIPAA act 1996 and Compliance.
13 JUL 2015 – 13 JAN 2017 – Mumbai, India
Executive (Revenue Cycle Management- Account Receivable) eClinicalworks Pvt. Ltd
My responsibilities included, follow-up on pending revenue. Working on a patient's account unless it gets zeroed out. Soft-core collection process, calling insurance companies for payments and billing patients. It is a renowned software as well as first party billing company which develops Electronic Health Record. It is fully automatic tool for providers which help them from preparation of patient's demographic information, appointment scheduling, and progress notes till conversion from encounter to claim. Learnt front office, mid office, and back office workflow which includes, preparation of patient's demographic information, adding insurances (primary, secondary & tertiary), checking benefits & eligibility, encounter, progress notes, coding, ICD-CPT linking, Ready to bill process converting front, mid & back office process into a standard CMS 1500 & UB-04 claim form and submission. Working on denial claims. Downloading ERA’s from clearing house, websites, reading EoBs (EoPs, ERAs) and follow-up as per the denial. Strictly obeying HIPAA act 1996 and Compliance. 22 DEC 2014 – 30 JUN 2015 – Mumbai Suburban, India Senior Analyst (Revenue Cycle Management- Account
Receivable) Inventurus Knowledge Solutions,
It was an end to end soft-core collection process; I was handling all types of denials and was working toward resolution for provider getting paid. There were more than 500 in-network providers (MD Anesthesiologists) aligned to Valley which is in- network with thousands of insurance companies across USA. It was a business to business process. My work was included, contacting insurance companies across USA and asking them to process or reprocess claims & payment (in case of denial or in case of underpayment, was checking standard fee schedule, contract, calculation of base units, time units etc.).
Checking patient’s eligibility, benefits with insurance and accordingly billing to insurance. Creating task for patient calling. Running complete Revenue Cycle Management of an insurance claim. It includes, Electronic as well as paper claim submission, i.e. re-billing, swiping insurance, patient billing, changing responsibility etc. creating courtesy, normal appeals, submission of medical & other records with fax cover sheet and reconsideration, complete on-shore work, follow-up till getting payment from insurance. Strictly obeying HIPAA act 1996 and Compliance.
28 OCT 2013 – 31 DEC 2014 – Mumbai suburban, India Information clerk (Senior- Customer care executive) Serco Global Services, India
Coram home infusion services. My job profile was to contact insurance companies across USA for payments, claims of patients & getting the current status, follow-up on denial claims for getting payment and updating status into client software. Was working on CMS-1500 & UB-04 form. It is second largest company in USA which deals with durable medical equipment, drugs & prescription i.e. Medicare part D and act as a healthcare provider. They provide Nurse services, Entreal supply i.e. tube feeding, Intravenous set, Scalp Vein set, saline water and other solutions etc. This was a business to business process. Strictly obeying HIPAA act 1996 and Compliance.
EDUCATION AND TRAINING
Master of Science
Mumbai University
https://old.mu.ac.in/
Bachelor of Science
Saint Gadge Baba Amaravati University, Amravati
https://www.sgbau.ac.in/
LANGUAGE SKILLS:
MOTHER TONGUE(S): English
OTHER LANGUAGE(S): Hindi
Listening Reading Spoken Spoken Writing
C1 C1 production
C1
interaction
C1
C1
Marathi
Listening Reading Spoken Spoken Writing
C2 C2 production
C2
interaction
C2
C2
Career Objective:
History of orchestrating consistent progress in generating revenue. Initiative in handling clients, critical tasks, Strong background in revenue cycle industry (RCM). Maintaining quality as per the service level agreement. Inventory planning, allocation management among auditors, operations and oversight experience with 7+ years’ in progressive roles. Excellent verbal and interpersonal skills, refined relationship building skills, working collaboratively with clients. A conscientious dedicated professional.
Able to handle a high workload, result
oriented. My skills along with a strong
sense of professional integrity have
contributed significantly in my career.
Contact this candidate