Proems - Team Lead Payment Poster
April 2025 - Present
• Supervise the daily activities of the payment posting team.
• Ensure accurate and timely posting of insurance payments,
patient payments, electronic remittance advice (ERA), and
manual payments.
• Find missing EOBs for check payments to be posted
• Analyzed EOBs and remits
• End of month reconciliation of payment
• Helped other billers and payment posters with their questions
• Conduct regular quality audits to ensure posting accuracy and
compliance.
Stratford Cresson Partners - Team Lead Medical Biller
December 2024 - April 2025
• Checked claim status
• Supervise and support the daily activities of the medical
billing team.
• Monitor claim rejections and front-end edits to minimize billing errors.
• Processed claims and resolve denials to ensure maximum reimbursement identified issues to appropriate areas for review and response to expedite claim resolution
• Analyzed EOBs and remits
• Answered questions from other billers
Alaska Billing Services - Medical Biller
February 2023 - January 2025
• Performed posting charges
• Ensured patient’s information is accurate and up to date
• Performed completion of claims to payers
• Conducted duties in a professional and timely manner
• Submit billing data to appropriate insurance providers
• Process claims and resolves denials to ensure maximum reimbursement identified issues to appropriate areas for review and response to expedite claim resolution
• Insurance verification, authorization and appeals
• Analyze EOBs and remits
Concentrix/Highmark-HNAS - Supervisor
January 2018 - January 2023
• Took escalated calls from both members and providers
• Managed team performance for Highmark-HNAS LOB and Compcare Authorization Department.
• Accepted incoming calls from both members and providers for eligibility, benefits and claims questions for PPO and EPO plans.
• Make outbound calls to providers and member’s network to help member’s claim to be processed and paid.
• Helped members on their unprocessed and unpaid claims by coordinating with providers and networks for pricing.
• Helped providers on billing insurances and claim denials.
Concentrix Cigna - Supervisor
December 2016 - January 2018
• Managed team performance.
• Accepted supervisor calls from providers for eligibility, benefits, and claims questions for OAP and HMO plans.
• Took escalated calls.
Concentrix Cigna - Subject Matter Expert
August 2016 - December 2016
• Accepted incoming calls from providers for eligibility, benefits, and claims questions for OAP and HMO plans.
• Took escalated calls.
• Answered CSR’s questions about their call & task.
Concentrix Cigna - Customer Service Representative
December 2015 - August 2016
• Accepted incoming inbound/outbound calls from both members and providers for eligibility, benefits, and claims questions for OAP and HMO plans.
Experience: 5 - 10 years
I was on a customer service for more than 6 years handling inbound calls from members and providers.
Experience: 5 - 10 years
I worked for US medical insurance companies for more than 6 years. 2 years as customer service advocate and 4 years as supervisor
Experience: 5 - 10 years
With my experience working on medical insurance companies, I helped providers on how they bill their claims and explain to them what needs to be done to have it paid or adjusted. I worked for few medical insurance companies so I am knowledgeable on how they processed claims, authorizations and appeals. And also, I am familiar on their medical policies.
Experience: 5 - 10 years
“My business would not be able to go forward if it was not for them”
Gaurab - Adhikari
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