Thirupathi Arikilla

Thirupathi Arikilla-Mobile - Objective: To serve in an Entity where the requirements and environment will give me a chance to evolve, emerge skills, sharpen thoughts and knowledge which immensely gives a growth of Organizational and individual and fulfill the business needs. Health Care: 7+ years of experience in US health care Claims Adjudication. Worked on various health care claims in Medicare, Professional, Facility and Inpatient claims. Strong knowledge on health care data like Providers, Members data. Strong knowledge on working with health care components like ICD-9 and 10 diagnosis data, Procedure codes, TOBs, POS, remark code, reject codes and Adjustment codes. Professional Experience: 1. Working as Specialist in SS&C Technologies (DST Worldwide Services Pvt Ltd), Hyderabad from April-2015. Perform a variety of tasks related to Claims Scrutinizing Medical Claim documents and settlements Electronic and Paper by using the software MHC and AWD. Process claims as per healthcare guidelines adhering to PHI. Knowledge of policy concepts Deductible, Coinsurance, Co-pay, Out of Pocket, Maximum inside limits and Exclusions, State Variations. Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair processing of claims and contribute to a reduced loss ratio. Pay and process claims within designated authority level and TAT. Timely and accurate adjudication of all types of claims from assigned workflow queues. Effective communication with Supervisors/Peers verbally or in writing regarding claim issues, including claim adjudication, overpayments, underpayments, billing problems and any other irregularities. Documentation and reporting back to superiors. Support the work to resolve claims that suspend in work queues and clearing by the final conclusion with lead and superiors. Strictly adhere to the Process Policy and Procedures and interacts with leads and superior if any discrepancies occur. Widely using NPPES to get the correct provider and facility information. Performing quality audits of new joiners and suggest them to good quality work procedures. 2. Worked as Process Associate in Sutherland Global Services from Feb-13 to Aug-2014. Worked in Provider Demographics data process, where we used to evaluate and validate the correct info as per NPPES. Updated the proper information of providers and search for Duplicates, find out the original provider then removes the Duplicates by terminations. Achievements: Sutherland Global Services: Received Appreciations from the Department Head for the Quality of Work. I served 18 months in the organization and awarded with Incentives for 6 months. DST: Joined as Sr. Associate, Initially worked for MDWise client and worked hard for meet the team SLAs with quality of work, received client appreciations. Received numerous Star of The Month award just in one year of service in MDWise process. Promoted as Specialist, then Moved to New Project as Pilot batch team member. Participated in Train a Buddy Program and trained 2 New Joiners. Created few Macros in MHC applications and saved the cost of $5000 for organization. Joined in Delta Sigma Clubs for my achievement in macros. And Awarded by India Head of SS&C. Academics: 2014: M.Sc Microbiology-Gauthami PG College, -Osmania University-62%. 2009: B.Sc Biotechnology- SRR Govt.Degree College, - Kakatiya University-56%. 2006: Intermediate- Sadhana Jr College, - Board of Intermediate Education -76%. 2004: SSC- Z.P.H.S, - Board of Secondary Education-77%. Application Skills: Microsoft Office: Good at Excel, reporting and power point presentations. MHC, AWD. Strengths: Attitude to work hard with dedication and determination Quick Learner and Self-motivated interpersonal, analytical and problem solving skills. A good team player with everlasting threshold to learn new things. Willingness to walk the extra mile to achieve excellence. Good communication/ Presentation/ Time management/Mentoring and Training skills. Added Certifications: Post Graduate Diploma in Computer Applications. Declaration: I hereby declare that the above given information is true to the best of my Knowledge Date: Place: Hyderabad (Thirupathi. A)