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[QUOTE=Guest-IJT;136332][b]Name [/b]: K.S.KIRAN
[b]Email [/b]: deekshanit AT yahoo.co.in
[b]Designation / Skillset[/b] : Senior Process Executive
Senior Process Executive

[u][b]Resume[/b][/u] :
 
OBJECTIVE
Looking for growth in new environment, and ability to refine myself into the new environment and better environment and better thinking as per my organization standards.
PROFILE
I started my career in this industry with Novel Team Pvt Ltd., as a processing exectutive and became versatile with patient demographic information, Encounter forms and Charge sheets. After a brief period in the charge division based on my performance, I was moved to the cash posting division to handle cash applications and study the payment pattern from the diffent HMO Plans and slowly moved to Analyst part. Using this opportunity I was able to give recommendations through which the client was able to increase the reimbursement in certain plans. Looking at more exposure, I joined Boavista Business Solutions Pvt LTd., as an Denial Analyst Executive. My areas of operation in this would be issuing follow up calls to the call center, handling denials, resolving provider issues, participate in Tele-conference, following on Ern enrollment and provider enrollment issues.
PROFESSIONAL QUALIFICATION
IBM E-Business
Pentasoft Technologies Pvt Ltd.,
Bangalore India.
EDUCATIONAL QUALIFICATION
Bachelor of Science BSc(electronics)
JSS College of Arts & Science.
Affiliated to Mysore University, Mysore, India.
ADDITIONAL QUALIFICATION
Advanced Diploma in Computer Applications from Brilliants Computer Center
Cunningham Road Bangalore E-commerce course
Active Server Page (ASP), XML,WML
ORACLE 8I
Visual Basic
PERSONAL SKILLS
comprehensive problem solving abilities
Ability to deal with people diplomatically
Team facilitator
WORK EXPERIENCE
[b]Organization  [/b]: Lloyds Solutions Pvt Ltd., Bangalore
[b]Designation  [/b]: Process Executive
[b]Duration  [/b]: April 2010 to till Date
Worked as Charge Entry Quality Analyst maintaining Patient Demograhics, Charges and Insurance 
details. My job was to handle a team of 10 members wherin my job was to monitor them and to
maintain accurate quality issues conserned to patient demographics and charges. We had nearly
about twenty clients of different specialities like Peadrics, Radiology, Gynecology, Podiatrics, ENT
Specialization and Internal Medicine. My job was to do quality checking for these specialization based
on the client updates.
[b]Organization  [/b]:Boavista Business Solutions Pvt Ltd., Bangalore
[b]Designation  [/b]: Process Executive
[b]Duration  [/b]:2005 to March 2010
Research unpaid and denied insurance claims to facilititate the processing of claims and receipt of payments from insurance companies.
Submission of letters of appeal on denied insurance claims,completing adjustments and working series accounts.
Maintenance of accurate patient and insurance data, i.e. medical records, explanation of benefits, demographics, etc.
Secures needed medical documentation required or requested to ensure account resolution.
Documenting the information on the calls.
Monitors claims for missing information, authorization/Control numbers.
Interacts with staff and customers to research and resolve less complex problems/Issues.
Maintains confidentiality of all information in accordance with HIPPA.
Setting up goals for every week and keep on monitoring the same on daily basis.
Doing random quality checking of analysis report & calling status and as well as the account status.
Following up with the Client related to some specific issues on Monthly basis (Like action required at their end).
Every week sending the Status report of each and every accounts and prepare a consolidated status of Insurance wise and their Total number of dollars outstanding.
Action plan has been set accordingly in addressing of all the accounts.
Guiding the freshers on call handling
[b]Organization  [/b]: Novel Team Pvt Ltd., Bangalore
[b]Designation  [/b]: Process Executive
[b]Duration  [/b]: January 2004 to April 2005
Working on Denial claims,Solving issues.
Post/Update the report into computerized ADS Billing System.
Handling Patient Calling.
Verifies and updates patient insurance and demographic information.
Follows-up on past due balance,payment plans and collection of co-pays and self pay payments.
Works all account receivable and submits necessary documentation to ensure payment.
Ensure all patient financial information is verified and accurate and enters that information into the appropriate computer System(s)
Working on Workers compensation claims.
Total control of documents to ensure that all documents are processed
Total control of documents to ensure that all documents are processed
Total control of Patient Ar.
Quality analysis on Demographics, Charge entry and AR follow up
Co-ordinate with others in planning and organizing work
Communicated with others in planning and organizing work
Communicate with client on operational issues
Maintaining MIS report for the production of patient demographics & charge entries
Action on denials & refilling of denied claims.
Making calls to insurance companies regarding the claim status,mailing address & eligibility status.
Preparation of weekly reports & monthly reports to the client.
Supervise the day to day activities of the team members.
Preparation and maintenance of the productivity details of the team members..
[b]Organization  [/b]:Pentasoft Technologies Pvt Ltd., Bangalore
[b]Designation  [/b]: Faculty
[b]Duration  [/b]:January 2002 to December 2003
Managed and conducted the co-ordination of different courses of software management
[b]Organization  [/b]:Natesan Anti Quartz Pvt. Ltd.,
[b]Designation  [/b]: Data Entry Operator
[b]Duration  [/b]: January 2001 to January 2002.
Worked as Data Entry Operator
[b]Organization  [/b]: JSS Hospital, Bangalore
[b]Designation  [/b]: Assistant System Analyst
[b]Duration  [/b]: January 1995 to December 2000
Worked as Assistant System Analyst, maintaining patient demographic details, billing and inventory control.
Taking backup and creating reports.
 
[b]Swot  [/b]: My strength are people management.
Communication, punctuality & time management & dedication & Sincerity to do the work in a short & simple way. 
Accepting others comments easily and working on that at the earliest if I realize I am at fault, I feel, feedbacks from the other or the superiors can only mould me from accurate to perfect.
I always believed Customer Support and Client support is my cup of tea and worked hard to be in a comfortable position.
I hereby declare that the above-mentioned details are true to the best of my knowledge.
[b]Place  [/b]: Bangalore
[b]Date [/b]:
 (K.S.KIRAN)
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More Information about this submission and submitter:-
___________________________________________________
Submission ID : 4356346
Date & Time : 11th Jul 2011 5:52 AM (UTC)
IP Address : 121.243.187.246
Browser Info : Mozilla/4.0 (compatible; MSIE 8.0; Windows NT 5.1; Trident/4.0; .NET CLR 1.1.4322; InfoPath.2)
Predicted Country : India[/QUOTE]

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