Guest Lecturer Data Entry
Resume:
Medical Claims processor
PROFESSIONAL SUMMARY
Self-motivated, Medical Claims processing professional with 3+ years of relevant experience available to offer professionalism and thoroughness to an insurance or medical company in need.
SKILLS
New Policies Processing
Claim Validity Determination
Problem-Solving
Insurance Claim Form Review
Medical Terminology
Proficient in using Computer System and Microsoft Office
Ability to write reports using healthcare and medical terminology
PROFESSIONAL EXPERIENCE
mediassist insurance tpa pvt. ltd. mumbai, india
Medical claim analyst march 2014 – February 2015
Accurately processed large volume of medical claims.
Evaluated pending claims to identify and resolve problems blocking auto adjudication.
Based payments or denials of medical claims upon well-established criteria for claim processing.
Sent Clinical requests and missing information letters to obtain, incomplete information.
Reviewed administrative guidelines whenever questions arose during processing of claims.
Verified policy holder data including age, contact number and physical address.
Checked documentation catching errors and making revisions.
Instructed clients on amounts covered under benefits plans in easy to understand terminology.
Modified, updated and processed existing policies and claims to reflect changes in beneficiary, amount of coverage and type of insurance.
Processed claims for payment or forwarded to appropriate personal for further investigations.
Updated patient and insurance data and input changes into company’s computer system.
Examined claims, records and procedures to grant approval of coverage.
Retained strong medical terminology, understanding in effort to better comprehend procedure.
mediassist insurance tpa pvt. ltd. Mumbai, India
Medical claim Processor September 2012 – May 2013
Accurately processed large volume of medical claims.
Evaluated pending claims to identify and resolve problems blocking auto adjudication.
Reviewed claims for accuracy before submitting for billing.
Inputted data into system, maintaining accuracy of provider coding information and reported services.
Tracked differences between plans to correctly determine eligibility and assess claims against benefits and data entry requirements.
Based payments or denials of medical claims upon well-established criteria for claim processing.
Sent Clinical requests and missing information letters to obtain, incomplete information.
Reviewed administrative guidelines whenever questions arose during processing of claims.
Checked documentation catching errors and making revisions.
Instructed clients on amounts covered under benefits plans in easy to understand terminology.
Modified, updated and processed existing policies and claims to reflect changes in beneficiary, amount of coverage and type of insurance.
Processed claims for payment or forwarded to appropriate personal for further investigations.
Updated patient and insurance data and input changes into company’s computer system.
Examined claims, records and procedures to grant approval of coverage.
Retained strong medical terminology, understanding in effort to better comprehend procedure.
Ambulance Service 108 bhopal, india
Emergency Medical Technician - paramedic (On Job training & INTERNSHIP) Mar 2008– August 2008
Administered life support, first-aid treatment and other forms of prehospital emergency care to people who are injured or sick.
Operated equipment such as bag valve mask resuscitators, external defibrillators and electrocardiograms for advanced life support applications.
Administered drugs as appropriate and necessary via injection, intravenous procedures or oral administration under the direction of a physician.
Nutan girls coleege bhopal, india
Guest Lecturer Nov 2008–Dec 2009
Taught allied subjects/courses like anatomy and physiology to hospital management students.
Assist with the coordination and review of the Allied Health Program curriculum.
Evaluated students’ knowledge and progression within the program by using a wide array of assessment tools.
Promoting students’ success through growth based feedback.
Timely communication and implementing and divers learning strategies.
EDUCATION
Bachelor of Homeopathic Medicine and Surgery, August 2008
Narayan Shri Homeopathic Medical College, Bhopal, India
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