Jishnu Mohanan

JISHNU MOHANAN Email:-Contact No: - Mangadankattill House Madaplathuruth Moothakunnam P.O North Paravur Cochin, kerala-683516 India CAREER OBJECTIVES Seeking a position in Medical/Insurance/Hospital field where I can utilize my experience and skills in a teambased environment. PROFESSIONAL EXPERIENCE ❖ Designation: Process Lead BPO Organization: UST Global Duration: October 2018 (Currently Working) ➢ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ➢ ▪ ▪ ▪ ▪ Job Responsibilities: Monitor, identify and resolve team performance (SLA)/behavior/attendance issues using prescribed performance management techniques. To effectively and efficiently ensure team s adherence to client provided SLAs for quality, productivity, TAT and schedule adherence is maintained Responsible for shift staffing, roster management and inventory management Conduct regular coaching, mentoring and feedback sessions with direct reports Create, update and maintain process documents, checklists Perform quality audits, identify, classify and prioritize errors and decrease the same by effective planning, Conduct training and refresher sessions Review team productivity & quality reports daily and provide constructive feedback. Ensure training needs are met Adjust to the needs of meeting SLAs under supervision of Manager Facilitate all client related training (existing / new clients), oversee process transitions and keep record of the same Prepare relevant process manuals & documents, monitor & update process changes through proper version control procedure (SOP). Communicate all process and client changes within specific timelines and keep record for such updates Act as single point contact for the assigned team members for all their job-related needs and create a harmonious work environment. Areas of Specialization / Industry expertise: Benefit coding for US medical insurance. Medical billing and medical coding knowledge. US Claim processing hands-on experience. Maintain Patient Health Information’s (HIPAA) 1 ➢ Skills Strong proficiency in Microsoft Office applications Word, Excel, PowerPoint and Outlook Excellent written and oral communication skills Experience in building management ▪ ▪ ▪ ❖ Designation: Sr. Associate Organization: Navigant BPM India Pvt Ltd Techno park Trivandrum Duration: January 2018 to October 2018 ➢ Job Responsibilities: ▪ ▪ ▪ ▪ ▪ ▪ ▪ ➢ ▪ ▪ ▪ ▪ ▪ ▪ Deliver Daily targets for claims/ DOS transaction assigned with quality Should have. (SLA) Maintain Patient health information’s confidentially. (HIPAA) Take appropriate action on claims to guarantee resolution. Ensure accurate and timely follow-up where required. Review denials with Billing Account Liaison to determine necessary steps for claim review. Document actions taken in claims billing summary notes Review team productivity & quality reports daily and provide constructive feedback. Areas of Specialization / Industry expertise: Accounts Receivable Payment posting Physician Billing Insurance Follow up Charge Entry, Demographics Denial Management ❖ Designation: Subject Matter Expert (SME) in RCM Organization: EXL services Duration: November 2016 to January 2018 Joined as Associate on October 2014 and promoted as SME on November 2016. ➢ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ Job Responsibilities: Focused efforts on decreasing the AR>60, increasing cash, reducing bad debt Apply payments and denials to third party carriers in all media types Interpret Explanation of Benefits for appropriate follow up action Complete refunds / adjustments to customer’s accounts, while providing necessary back - up information in order to maintain accuracy Contact third - party carriers to follow up on denied and un - responded claims Release electronic files and resolve error reports Analyze and apply denials Process and review claims Complete timely carrier recoupment requests 2 ▪ ▪ ▪ ▪ ▪ ▪ ▪ ➢ Evaluate and respond to all aspects of written billing inquiries from the patient or their representative in order to resolve billing issues Make have contact with insurance carriers, clients, patients and / or other outside sources Regular research involving both the web and billing systems Always Maintain Compliance and HIPAA standards Meet or exceed daily production standards (SLA). Meet or exceed daily quality standards (SLA). Ability to work on various other projects as needed Areas of Specialization / Industry expertise: ▪ ▪ ▪ ▪ ▪ ▪ Accounts Receivable Payment posting Physician Billing Insurance Follow up Charge Entry, Demographics Denial Management ❖ Designation: Transaction Analyst Organization: XEROX India Pvt ltd (ACS India Pvt ltd) Duration: June 2011 to October 2014 ➢ Job Responsibilities: ▪ Deliver Daily targets for claims ▪ Adjudication & process of Claim. (US Health Claims) ▪ Examination of Medical records. ▪ After analyzing the Doctors request, Re-processing the Claim. ▪ Take appropriate action on claims to guarantee resolution. ▪ EOB Creation ➢ Areas of Specialization / Industry expertise: ▪ ▪ ▪ ▪ In-Patient & Out Patient claims processing experience Validates the information on all medical claims from patients seeking payment from their insurance company. Claims must be thoroughly reviewed to ensure that there is no missing or incomplete information. Keeping meticulous records of claims and follow-up on lapsed cases. Approve or deny payment to doctors, it is vital that they know how to correctly read and assess medical documents. SUMMARY OF QUALIFICATION Qualification B. Com with Taxation Institution and Board/University MG University Kottayam Year of Passing 2014 Percentage of marks 59% 3 HSC SSLC Kerala State Board Kerala State Board - 51% 55% ADDITIONAL INFORMATIOON ▪ Completed 6 Month training in AAPC CPC Medical coding with ICD10. PERSONAL DETAILS Age Date of Birth : : Marital status : Sex Languages Known : : 29 26/08/1990 Married Male English, Tamil, and Malayalam. PERSONAL STRENGTHS ➢ Team Player ➢ Hardworking ➢ Leadership Quality and Multitasking ➢ Comprehensive problem-solving ability REFERENCES Reference upon request DECLARATION I do here by declare that the above-mentioned details are true to the best of my knowledge Jishnu MM 4