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PHONE NUMBER AVAILABLE, EMAIL AVAILABLEProfile SummaryExperienced professional with a strong background in claim eligibility, data entry, and validation, aiming toleverage these skills in a role that combines data analysis with medical billing in the healthcare sector.Skilled in ensuring accurate healthcare data management and billing processes, I am dedicated toenhancing operational efficiency and supporting effective decision-making. My goal is to contribute toimproved patient care and financial optimization through meticulous data scrutiny and validation.ExperienceRelivTek Inc., Data Analyst, July 2023 till dateI work as a data analyst for a Big 4 as a client. Key responsibilities include: Working on platforms like Aspen, Sales Force to review Medicare applications. Review applications based on income requirements, accuracy and completeness. Review Medicare applicability based on key state and federal requirements. Validate application details including SSN verification, residency, family status, household, incomestatus while performing review of the application. Run eligibility based on the verified requirements and certify requirements to be setup forapproval process. Provide weekly reports to management on applications processes and their status. Attend daily standup meetings with project team to review backlog and open applicationrequirements.GUIDEIT, Medical record abstractor, Mar 2021-May 2023I work as a medical record abstractor. Key responsibilities include: Working on healthcare systems like Epic, Cerner, Nextgen, Citrix, Athena & Greenway Abstracting the documentation of patient records, identifying problems, allergies, medications,immunizations, past medical records, histories, surgeries, family histories and many more dataelements. Data validation for accuracy and completeness is then performed from one system to another andidentified anomalies are corrected. Working in another project for dental abstraction where I go through all the dental procedures andcode done by the doctors including fillings, composite filling, amalgam fillings, caries, Xray,extractions, missing tooth and planned procedures. Transferring all the correct records from one Epic instance to another Maintain and review client and project documentation leveraging SharePoint, MS office andAdobe documents.EquinoxPPS, AR Specialist, Mar 2021-May 2022 (Part Time)Worked part time with a medical service provider supporting hospitals to verify eligibility and benefitsof a patient so that patients don't have to pay more after their visit to doctor, medical or mentalservices. Key responsibilities include: Get the correct modifier and CPT codes so that insurance doesn't deny the claims. Gather information on Medicare and Medicaid eligibility for the patient including Policy,deductible, Copay, Coinsurance, effective dates and terminating date, balance left for the year Communicate out of pocket maximum and accumulation to the patient Follow Up with insurance companies for clearing the claims. Handle all insurance bills through multiple insurance companies like United health, Aetna,Liberty mutual and many more insurances and supplemental plans Create weekly summary reports on claims and share it with the medical provider for accountreceivablesQuadraMed Inc., Medical Record Validator, Dec 2019- Feb 2020Worked as a medical record validator to identify, correct & prevent patient identification errors.Key responsibilities include: Analyze patient records to identify and correct data de-duplication Highlight data errors and correct on Smart ID and Smart Access Platforms Share data and reports for management analysis Perform QA review for additional data sets as required Work item tracking and analysis for timely completion of tasks and deliverables Maintain document cadence for the project leveraging documentation tools including SharePoint &teams.Tekleaders Inc., IT Recruiter, Aug 2018-till Nov 2019Worked as a recruiter to support few IT companies on fulfilling open requisitions for their organizationsand projects. Key responsibilities include: Execute overall recruiting strategy based on demands and open requisitions Develop and update job descriptions and job specifications Source and recruit candidates by using job search portals, social media etc. Screen candidates resumes and job applications Coordinate with client HR teams to scheduling candidates interviews and discussion Perform job and task analysis to document job requirements and objectives Prepare recruitment materials and post jobs to appropriate job board/newspapers/colleges etc.BSNL, Data Entry Operator, 2002-2005Worked as a data entry operator for the largest telecom company in India to support their digitizationproject. Key responsibilities include: Digitalize the paper copy transactions into an electronic record filing system Call end users for data validation as required Provide customer service to end users as necessary Use to perform more than 250 electronic upload transactions per dayEducation Bachelor in Arts, St, Xaviers College, 2001 DCA Computer Science, ATS Infotech, 2001 UDemy Online Course in Medical Terminology, 2019 Medical Billing Certification, Collin college, 2020Computer & Application skills:Document proficiency leveraging MS Office, EPIC, Cerner, Athena, MS Excel, Outlook, Teams & SharePointAchievements: Awarded employee of the month twice in Guide IT Obtained scholarship of 10000 INR from BSNL Group of Industries in 2002 Ranked A+ in S.S.C. merit list Won best team member award for 3 consecutive quarters in 2003 in BSNLExtracurricular activities: Lead the college fest RATRA Member of the organizing committee of JAGRUK Volunteer in North Texas Food Bank |
