Mar 2025 – Present · 1 yr · Gurugram, Haryana, India · On-site

• 1.Proactively follow up on outstanding insurance claims (commercial payers).Investigate and resolve denied or underpaid claims through appeals and reconsideration processes.Analyze payer trends and take corrective actions to prevent recurring issues.Work closely with payers and providers to ensure accurate claim adjudication.
• 2. Handling High-Dollar & Complex Claims
• Take ownership of high-dollar claims and ensure they are processed efficiently.Perform in-depth research on claim denials and reimbursement discrepancies.Coordinate with internal teams and insurance payers to resolve escalated claims.
• 3. Mentoring & Buddy-Up for New Joiners
• Provide training and guidance to new hires on AR processes, payer guidelines, and follow-up strategies.Conduct buddy-up sessions to help new team members understand workflows, systems, and best practices.Act as a point of contact for new joiners, answering queries and providing performance feedback.
• 4. Process Improvement & Additional Responsibilities. Identify inefficiencies in the AR process and suggest improvements.
• Participate in team meetings, reporting sessions, and workflow optimizations.
• Assist in auditing claims to ensure compliance with company policies and payer regulations.
• Support leadership in managing workload distribution and achieving key performance metrics.
• 5. Reporting & Documentation
• Maintain accurate documentation of claim status, payer interactions, and resolutions.
• Generate reports on AR aging, denial trends, and recovery performance.Provide insights and recommendations based on data analysis to improve collections.

Jan 2024 – Mar 2025 · 1 yr 2 mos · Gurugram, Haryana, India · On-site