Industriemeister/in - Qualitätskontrolle

• Hauptfach: Chemistry, Zoology and Botany

Biological Sciences, Genetics, Chemistry, Zoology and Botany

Appointed as an Auditor, auditing Client's work, particular emphasis on revenue generation. Client interactions / calls, team meetings, team handling experience of 20+ QAs, leave management, taking care of SLA & KRA, briefing updates, updating daily QAT & DPT, Working on DPO and DPU. Extracting, preparing reports from client's software, allocating them, Preparing Dashboard weekly, monthly, analysis of quality percentage & error type, error percentage & preparing Error Pareto, Bottom Quartile Management. Biller wise root cause analysis, feedback & coaching.

My responsibilities included follow-up on pending account receivable, working on all types of denial insurance claims, calling across USA to the insurance companies. Learnt front office, mid office, and back office workflow which includes, preparation of patient's demographic information, content editing, preparing content for client and co-coordinating with them, checking benefits & eligibility, encounter, progress notes, ready to bill process converting front, mid & back office process into a standard CMS 1500 claim form.

Worked on all types of denials and was working toward resolution for provider getting paid. Worked for more than 500 in-network providers (MD Anesthesiologists) aligned to Valley which is in-network with thousands of insurance companies. Contacting insurance companies across USA, making them to process or reprocess claims & payment.

Coram home infusion services. Job profile, contacting insurance companies across the USA regarding claims of patients and getting the current status, follow-up on denial claims for getting them resolved, for payment and updating status into client software.

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