Customer Service Accounts Receivable
Resume:
Kushbu Patel
!: *************@*****.***
Summary
• Four years of experience in Healthcare industry, on the Providers end. • Experienced working on claims for all the payers with a proper resolution, such that the claims are settled and end up paying to the provider.
• Thoroughly researched newly identified diagnoses and medical procedures to expand skills and knowledge.
• Accurately posted and sent out all medical claims.
• Submitted electronic/paper claims documentation for timely filing.
• Precisely evaluated and verified benefits and eligibility.
• Extensive knowledge in Billing the claims to the payer, identifying the claims which are billed with the incorrect policy id#, identifying the claims that were billed to incorrect payer with incorrect information on the claim by the running the weekly report
• Knowledge on how to run the information in the payer website for getting the member details and their plan information
• Performed billing and coding procedures for ambulance, emergency room, inpatient and outpatient services
• Identified and resolved patient billing and payment issues
• Posted and adjusted payments from insurance companies
• Responded to correspondence from insurance companies
• Identified and resolved patient billing and payment issues
• Maintained and updated collections tracking spreadsheet to help organize payment information
• Confidently and adeptly handled claim denials and appeals
• Reviewed and resolved claim issues captured in TES/CLAIMS edits and the clearing house • Examined patients’ insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable • Prepared billing correspondence and maintained database to organize billing information • Expertise on all payers, how they work what are the issues for a particular payer, which payer follows flat rate payment.
• Knowledge on Appealing the Medical records to the payer with the attached necessary documents that are required to process the claim.
Skill set
• Familiar with commercial and private insurance carrier
• Excellent communication skills
• Strong analytical skills in assessing current and future market trends
• Strong interpersonal, coordination, and organizational skills
• Strong customer service skills
WORK EXPERIENCE:
Cognizant Technology SoluLons
Healthcare–Accounts Receivable Process Outbound Calling ResponsibiliLes:
• Patient Account maintenance.
• Insurance Account Maintenance
• Hands on experience Medicare, Medicaid, Health scope, BlueCross, Blue Shield, Aetna Insurance.
• Worked for Workers Compensation
• Payments were posting on the client system.
• Tracking timely payments are made by Insurance Companies
• Checking discrepancies & maintain 100% accuracy.
• Assist in an end to end resolution until reimbursement is received.
• Analyzing all Claims disputes, and contacting the insurance company to collect the required details.
Awards and Achievements
• Won the Best Performer award
• Provided Training for new joiners
• Were assigned additional responsibilities for doing an outstanding performance and reaching the goal
Infinix Healthcare soluLons
ResponsibiliLes:
• Worked as a Sr. Associate in Pilot batch
• Worked on emails received from clients and on high priority claims
• Was responsible for assigning work to the team members
• Played a significant role in providing training to new joiners
• Expertise handling client and their Issues.
• Responsible for tracking down the daily production report and the Quality report for the team members.
• Was a proactive team player with high standards of self-motivation, who constantly strived on quality aspects and achieving Service Level Agreements within the stringent stipulated timeframes, without compromising on the quality of the deliverables MP OIL LLC
Worked as Accountant
• Assist in overall accounting of the Company
• Conduct transfer of data from Manual to Electronic
• Train and Oversee the staff in reporting transactions from various departments
• Work with the HR department in maintaining HR budget and payroll Awards and Achievement
• Was the first person to receive an award for the best performance in 2014 quarter • Training new hires
• Attended the client calls for all the updates.
EducaLon
Bachelor of Science from St. Pious X Degree College for women, Hyderabad, India. Masters in Business and Administra?on from Schiller interna?onal University, Florida, USA
Contact this candidate