R. Parameswaran
Contact: -
Email:-
Career Objective
To learn and develop, myself and the organization with innovative ideas, by applying my thought, knowledge and various principles in my field, with the help of technology, friends and my colleagues.
Work Experience
Clinic anywhere (USA), Work From Home, India (January 21, 2019 to Till Date)
(AR Analyst)
Access Health Care, Chennai (May 18, 2018 to January 03, 2019)
(Senior Client Partner)
Medi-smart Solution’s, Madurai (April 2015 to May 2018)
(AR Caller, Rejection, Denial’s, Payment Posting and Claims creation)
Omega Health Care, Trichy (Sep 2013 to March 2015)
(Payment Posting)
Software’s worked
Kereo
WRS Health
Athena
Health Fusion
What I do
Insurance Verification Process:
Check Eligibility
Verify coverage on all Primary and Secondary Insurance
Check Benefits for both in Network and Out of Network services
Obtain Authorization’s if needed
Contact patient if information such as Referrals or medical records needed
Claims Creation:
Enter and check the billing details of the patient in the Billing software
Enter and check Referring/ Rendering provider’s information
Enter and check the primary payer & secondary payer’s information
Enter and check the valid Diagnosis codes & Procedure codes for the service date
Adding modifiers if required
Enter and check required billed amount for each procedures
Submitting the claims to payer in a timely manner
Working on Rejection’s:
Rejected claims will not be processed because they are not considered to have been “received” by the payer, thus do not make it into the adjudication system.
Correcting Errors and resubmitting on a daily basis
Print and mail claims if not set up for Electronic Data Interchange
Accounts Receivables and Denial:
Any claims which remain unpaid for various reasons. These claims are routinely followed up on a monthly basis. The reasons for rejections include
Authorization Issues
Referral Issues
Medical Necessity and Medical Records requests
Non- Participation with Insurance Network
Terminated Insurance
Timely Filing
Coordination of benefits
Wrong Diagnosis
Bundled Procedures
Partial Payments
Out of network claim status and deductibles
EDI Rejections
No status and Claim not on file
Maximum benefit reached
Need Primary Insurance EOB
Maximum Reimbursement:
Claims are followed up systemically and rapidly. Claim follow up is handled utilizing our electronic clearinghouse, insurance web portal and direct contact via telephone. I diligently pursue the claims for maximum reimbursement and appeal the denials.
Aggressive Follow Up:
All unpaid claims are aggressively pursued daily. Expert at getting through to the insurance companies to dispute improper denials and slow payments.
Claim Appeals:
Denials and rejections are always handled by an appeal. Once the denial is evaluated, I utilize the appeal process to handle correct claims denials. Claims are never written off without being appealed first.
Follow Up process:
Use various insurance company websites and internet payer portals check on the status of outstanding claims
Automated claims Follow Up (IVR)
Insurance Company Representative- If necessary calling a “Live” Insurance company representative will give us a more detailed reason for claim denials when such information is not available from either Portals or Automated phone systems
Claim correction and Resubmission done when required
Attached additional documentation if required
Appeal if needed with Medical records or proof of timely filing
Bill patients for Deductible, Coinsurance and Co-payment
Bill secondary with Primary payer’s payment information
In cases where partial payment are made, necessary steps and analysis initiated, after which corrective steps are taken
Payment Posting:
Read EOBs/ ERAs accurately
Enter the payment details for each line item from EOBs accurately in the Billing Software
Transfer Patient balances
Create Deposit Batch on a daily basis
Review Auto posting
Upload EOBs after posting the payment in the Billing Software
Medical Billing Reports:
The Billing service monthly end report
The Accounts Receivable Aging Report
Key Skills
Ms Office
Following HIPPA Rules
Medical Billing
Medical Insurance
Online Claim Submission
Verify Benefits and Eligibility
Checked Insurance Web Portal, downloading the EOBs and also attached in billing software
Analyse the denials and took valid action
Submit the claims on time
Follow up the claims monthly wise
Clearing House
Trizetto Solution (Gateway EDI)
Phi cure
Academic Credentials
Year
Institution
Board /University
Qualification
Percentage/CGPA
2013
C.A.R.E. School of Engineering,
Trichy (T.N)
Anna University
B.E.(EEE)
6.34
2009
Vinmathee matriculation higher secondary school,
Manapparai, Trichy (T.N)
State Board
HSE
60%
2007
Vinmathee matriculation higher secondary school,
Manapparai, Trichy (T.N)
Matriculation
SSLC
53%
Achievements & Awards
So many times got star of the Month award
Got appreciation from the client’s
Personal Details
Name
Father’s Name
Date of Birth
:
:
:
R. Parameswaran
N. Ramasamy-
Languages known
:
Tamil (Read, Write, Speak)
English (Read, Write, Speak)
Gender
:
Male
Marital Status
:
Single
Nationality
:
Indian
Experience
:
9 years in Medical Billing
Declaration
To offer services that would reimburse our Health Care providers 100%. To shoulder responsibilities for the benefits of the concern and will perform the duties assigned to me and the team to the entire satisfaction with passion.
Place:
Date:
(R. Parameswaran)