Quality Assurance Medical Billing
Resume:
GNANANJALI
BATTU
***************@*****.***
Dallas, Tx
CONTACT
SKILLS
• Quality Assurance
• Validation
• Medical billing / coding
• SQL
• Power BI
• Azure
• MS office
• Attention to detail
• Time management
• Problem-solving abilities
• Adaptability and flexibility
• Team collaboration
• Decision-making
• Flexible schedule
• Leadership qualities
• Oral communication
• Computer skills
• Data entry
A detail-oriented and highly organized medical billing and coding professional with an year of experience, skilled in accurately processing and submitting patient claims to maximize reimbursement while ensuring compliance with all healthcare regulations, proficient in utilizing electronic health records(EHR) and industry-standard coding systems to streamline billing processes. Enthusiastic pharmaceutical graduate with knowledge of SQL,EXCEL,AZURE. Eager to apply technical skills in software development and contribute to innovative projects.
PROFESSIONAL SUMMARY
Associate
Prime Health Care, Hyderabad
Company Overview: PrimEra Medical Technologies
EXPERIENCE
January 2022 - December 2022
Claim Data Analysis and Reporting: Ensuring that insurance claims are processed and submitted correctly, analyzing claim data for errors and trends.
•
SQL Server: Writing queries to pull data from different sources such as claim submission systems, insurance databases and patient management systems.
•
Implementing business rules and validations for claims data to ensure
• compliance and accuracy.
Creating stored procedures to automate common tasks like identifying
• missing or incomplete claims data.
Excel: Organizing and analyzing billing data exporting from SQL server
• for reporting purposes.
Building excel reports to track outstanding claims, payer trends and
• patient billing histories.
Creating pivot tables and charts for easy visualization of key billing
• metrics like total revenue, denied claims and outstanding payments. EMR System Implementation: Successfully transitioned a clinic to a new electronic medical record (EMR) system, resulting in improved data accuracy and a 30% reduction in billing cycle time.
•
Coding Accuracy Improvement Initiative: Led a team training program on complex ICD-10, billing software, data analysis, coding guidelines, achieving a 98% coding accuracy rate across all coded patient encounters.
•
Specialty Coding Expertise: Developed and implemented specialized coding protocols for a specific medical specialty like oncology, cardiology optimizing billing practices and maximizing reimbursement.
•
Trainee
Finoso Pharma Company, US
Auditing and Compliance Project: Conducting regular internal audits of patient records to ensure adherence to billing regulations (Medicare, Medicaid), identifying and rectifying coding errors to maintain compliance.
•
Maintained up-to-date knowledge of organizational policies,
• procedures, and regulations.
Participated in team meetings, providing insights to improve
• operations.
• Monitoring and documenting the defects of equipment functionality Learnt Analytical reasoning, Data Analysis, Quality Management,
• Compliance, identifying flaws and recommending solutions MASTERS in Quality Assurance
Shri Vishnu college of Pharmacy
EDUCATION
October 2021
GPA 8.0
CERTIFICATIONS
• Gold medalist in Quality Assurance stream in post-graduation.
• Passed in pharmacovigilance certification program.
• Statistical Analysis System (SAS) certification.
Prime Health Care (PrimEra Medical Technologies), Associate, 01/01/22, 12/31/22, Hyderabad, India, Claim Data Analysis and Reporting, Ensuring that insurance claims are processed and submitted correctly, analyzing claim data for errors and trends., Writing queries to pull data from different sources such as claim submission systems, insurance databases and patient management systems., Implementing business rules and validations for claims data to ensure compliance and accuracy., Creating stored procedures to automate common tasks like identifying missing or incomplete claims data., Organizing and analyzing billing data exporting from SQL server for reporting purposes., Building excel reports to track outstanding claims, payer trends and patient billing histories., Creating pivot tables and charts for easy visualization of key billing metrics like total revenue, denied claims and outstanding payments., EMR System Implementation, Successfully transitioned a clinic to a new electronic medical record (EMR) system, resulting in improved data accuracy and a 30% reduction in billing cycle time., Coding Accuracy Improvement Initiative, Led a team training program on complex ICD-10, billing software, data analysis, coding guidelines, achieving a 98% coding accuracy rate across all coded patient encounters., Specialty Coding Expertise, Developed and implemented specialized coding protocols for a specific medical specialty like oncology, cardiology optimizing PROJECTS
billing practices and maximizing reimbursement., Auditing and Compliance Project, Conducting regular internal audits of patient records to ensure adherence to billing regulations (Medicare, Medicaid), identifying and rectifying coding errors to maintain compliance.
• Anti-diabetic activity of Carissa carandas aqueous fruit extract on Alloxan induced
diabetic rats.
• Review of Brain strokes.
• Formulation and evaluation of Ornidazole Topical Emulgels.
• Seminar on Auditing and types of Auditing.
• HSM natural, renewable, non-renewable and forest resources.
• Review of good documentation practice in the pharmaceutical manufacturing unit.
• Preformulating studies: Physicochemical characterization of new drug molecules.
SEMINARS
Contact this candidate