VIJAYALAKSHMI BHARATHI
Senior customer support executive
Abudhabi ,Abudhabi
Summary
I am passionate about learning new things and over the past 12 years of work experience in US Healthcare.I have proven history of improving operations and increasing profitability. Striving for excellence and hard work has been my hallmark throughout my experience.
Overview
12
12
years of professional experience
Work History
Lead
Sutherland Healthcare Solution
01.2021 - 04.2024
- New Hire Training
- Key responsibilities
- Creating the New Hire Training planner and sharing the same with internal stake holder
- Handling Team of 5 Sr Trainers who are process specific and dedicated to particular team/process
- Accountable for performance of the Sr Trainers and if required conduct the tech-back session as well sharing the feedback in presence of Training manager/Sr Training Manger
- Facilitate New Hire Training on Provider, Payer, Hospital Billing and Wex (TPA) Training
- Entire RCM basics that includes pre-process, process & systems for new hires, conducting assessment and publishing score card summary to leadership
- Training New Hires on various skills includes Mock call practice, formal Email writing and basic computing and typing skills
- Responsible for the new hires till completion of OJT along with maintain daily, weekly & monthly reports for the training team
- Accountable for training deliverables like yield, training quality and training on time when training a new hire batch
- Creating SOP for the new clients and existing projects by attending their client calls, walk through and sending the SOP’s for client approval for the team to follow during live
- Creating Workflow for the projects based on scenarios as per the SD requirements
- Conduction Training session and assessments for the Users moving internally from different domain to Healthcare
- Conducting process/domain related training (As & When required based on SD requirements)
- Process level analysis & preventive action planning for LOB/Associates
- As per the request from SD managers or any changes in client update, facilitate a refresher training for existing staff
- Coordinate with Assistant Manager/Manager Training to create training modules and update training modules
- Conducting Process Knowledge Test, publishing PKT score and PKT TNI session to associates who couldn’t clear PKT for the assigned process
- Conducting BQM training session on the scenario’s associates committed mistake for the previous month who dint met quality SLA
- Preparing Landscape report, MRM slides and BQM analysis (training point) on monthly basics
- Joining client weekly, monthly and calibration call with SD, Quality and
- Conducting Viva session for the experience associates on quarterly basics and sharing the scores with leadership team
- Conducting SHAPE certification to the experience users based on the nomination received by SD Mangers
- Responsible to conduct cross skill training for any process movement
- Below are the list of Client/Process for which provided process training: -
- Athena
- Columbia (AR, Billing, Rejection & Payment posting)
- OP Office Practicum (AR, Billing, Rejection & Payment posting)
- Northwell Commercial, Medicare, Medicaid & PAP (AR & PAP)
- Campcreek (AR & Billing).
Sr AR Associate
Sutherland Health Care Solution
08.2017 - 01.2021
- Key Responsibilities
- Client interaction Have been part of weekly service review calls, training calls, and process transition calls with the client and sharing the update to the team
- Mentoring program a key member in the mentoring program of the organization, wherein facilitating the new joiners (lateral and freshers) on the process and domain knowledge
- Adding, been an on-floor support staff in providing on-time support to the team members
- Quality Monitoring and feedback a key personnel in monitoring the performance of the team members via voice and non-voice/transaction auditing, which involves on call feedback, post call feedback, weekly quality meet, client quality meet etc.
- Analyzed different types of claims, which involves hospital and individual provider claims
- Analysis also involves identifying proper denial codes and its respective steps to resolve
- A key member in updating the process knowledge to the team
- Reports & MIS Have worked in formulating reports using the client tools
- The various reports involve
- Daily production, weekly production, quality consolidated report and dashboard
- These reports have been shared to the internal operations team and to the client
- Achievement: -
- Selected as Lead New Hire Training through internal career posting
- Got appreciation for Team Managing and worked as One Day Manager
- Rewarded as best performer 5 times for Keeping Production, Quality and Leaves more than SLA.
Senior Process Associate
Visionary RCM
12.2015 - 07.2017
- Worked on behalf of USA Healthcare Providers for the medical claims of Health insurance (Medicare & Medicaid), AUTO and Workers Compensation on their debts which were not paid by insurance companies
- Generating Revenue for the Providers and making the Process flow effectively by reducing the aging of the accounts
- Filing correct claims to insurance as per the provider contract for Providers/Facilities
- Performed detail-oriented filing appeals when appropriate to obtain maximum reimbursements, analyses accounts for under- payments or denials and submit appeals in a timely manner, review and understand correspondence received from insurance
- Verifying the Eligibility and Benefits of the Patients from the Insurance Companies.
Senior Process Associate
AGS Health
03.2014 - 12.2015
- Filing the claims to the insurance with UB04 forms and worked on Hospital Billing
- Auditing the work done New OJT associates maintaining the Client requirements in terms of Quality on Redetermination form and entire package
- Conducting the Briefing sessions frequently and ensuring the process move on with the latest updates
- Worked on behalf of USA Healthcare Providers for the medical claims of Health (Medicare & Medicaid, AUTO and Workers Compensation)
- Verifying the Eligibility and Benefits of the Patients from the Insurance Companies
- Filing the claims accordingly as per their eligibility
- Hands on experience with the websites like Navicure, Emdeon (Clearing house), Availity, Navinet, UHC, Medicaid, etc.
- Calling to the insurance companies for payments and working on the insurance denials.
Executive
E4E
11.2012 - 03.2014
- Worked on behalf of USA Healthcare Providers for the medical claims of Health (Medicare & Medicaid, AUTO and Workers Compensation)
- Verifying the Eligibility and Benefits of the Patients from the Insurance Companies
- Filing the claims accordingly as per their eligibility
- Calling to the insurance companies for payments and working on the insurance denials
- Worked on Clearing House rejection and TES and Claim Edits
- RegHRA edits to submit the claims
- Worked on Legacy AR claims to reduce the Claims Aging
- Healthcare Software
- Athena IDX & ECW.
Dental Northwell
- Got best trainer for 4 times
- Got appreciation and selected to facilitate Provider, Payer Training and Wex Process training
- Got Client appreciation on Facilitating Dental basic training and Creating Workflow and SOP.
Education
Bachelor of Mathematics - undefined
Dr.MGR JANAKI College for women
2012
Skills
- EPIC, ETM
- Dentrix & Centricity
- Healthcare Website and Tools:
- Encoder PRO, Availity (McKesson Edits), Navinet, Medicaid Of Texas, Medicare (CCI EDITS), Navicare, USPS
- Paper Claims Tracker), Right-Fax Corporation, Optum Optimix, Commercial Insurance webportals
- Proficiency
- MS Office
- Tally Prime
- Accounting Principles and Fundamentals
- Basics of SAP
- Basic Computing Skills
- Personal Profile
- Husband name : M BHARATHI
- DOB : 22-11-1991
- Gender : Female
- Marital status : Married
- Nationality : Indian
- Languages known : Tamil ,English
Timeline
Lead
Sutherland Healthcare Solution
01.2021 - 04.2024
Sr AR Associate
Sutherland Health Care Solution
08.2017 - 01.2021
Senior Process Associate
Visionary RCM
12.2015 - 07.2017
Senior Process Associate
AGS Health
03.2014 - 12.2015
Executive
E4E
11.2012 - 03.2014
Dental Northwell
Bachelor of Mathematics - undefined
Dr.MGR JANAKI College for women
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