• Review, manage and update company Policies, Procedures and Controls implementation to ensure Laws and Regulation are respected.• Work in collaboration with Stakeholders to create new Policies that meet Company requirements.• Create monitor and submit policies exceptions for closure for activities that occurred and are against Company’s procedures.• Assist in internal and external Audits activities, by acting as a Liaison, preparing meetings, gathering documentation and evidences and assisting during controls review.• Conduct Cyber-training programs for new and existing employees, and conducting campaigns such as Phishing on a monthly basis.• Provide monthly reporting to Upper Management in regards to environment cyber posture.• Reviewed violations of computer security procedures and developed mitigation plans.• Conduct monthly review for multiples domain related to off boarded users and report the management if any anomaly found during the review.• Creating the Risk IDs and provide it to relevant team to update as new risk and get the approval done from the relevant stakeholders.• Monitoring the SOX control one daily, weekly monthly and yearly basis and report to the management in the case of any issue found.• Managing two resources and guiding them whenever they need the support.• Managing the Cyber Security Incidents and engaging the relevant stakeholders on priority.

• Experience in Business Analyst in U.S healthcare include understanding of business requirement gathering, analysis and documenting it.• Functional knowledge of Medicaid management information system MMIS.• Having sound knowledge of Medicaid and Medicare domain of healthcare systems and industry of inpatient, outpatient Reimbursement methodology.• Extensively knowledge in the Member Enrollment and Billing information • Experience in Billing, claims payment processing in relation to HIPPA, EDI4010, 5010X12, ICD-09 & ICD-10• Strong knowledge of ICD-09 & ICD-10 business analyst with healthcare and able to understand the processing of ICD-09 and ICD-10• Having knowledge of SDLC (Software Development lifecycle) such as Agile, Waterfall and RUP.• Working knowledge of project lifecycle and clear undressing of project management • Having basics knowledge of JAVA, SQL • Having knowledge of office tools like MS word, MS excel, MS outlook and MS power point• Methodology (Agile, RUP, Waterfall)• Business Modeling tools (MS Visio)

• Responsible for account recoverable multiples healthcare providers in the USA• Analyzed the top denials for each client and identified solutions to increase cash and AR days • Reduced average days in A/R from 90 to 60 in 3-month time period and increased net collections from 65% to 80%.• Worked with clearing house like, Navicure / ZirMed, Availity, Emdeon and with payers to insure that all claims were processed and received by the insurance companies in timely manner • Reduced clearing house denials by 15% by analyzing denial reasons and submitting after correcting and guiding same to the team.• Maintain strong relationship with all clients and presented trends to them on monthly basis• Responsible for providing training and analytical support to the Revenue Cycle Senior Leaders and employees.• Researched and Analyzed revenue cycle trends.• Monitored revenue cycle and reviewed practice Administrators monthly financial reports.• Oversee various healthcare functions such as: Interpretation of managed care contacts and confirmation of correct reimbursement, Pre-registration, Insurance verification, Billing, Account follow up, Registration, Coding, Point of service Cash Collections, Cash Posting, Credential, Medical Records, Customer service collections

• Ensure complete review of claims and forward to correct insurance companies.• Contact insurance carriers or other responsible to confirm payment dates and details• Handle all claims on denial, rejections and no response work queue and follow up, review and document accordingly.• Contact patient for updated insurance information when necessary.• Make adjustment to the patient and insurance account • Perform timely and accurate submission of claims.• Created training manual for US healthcare billing and AR targeted at resolving and collecting the payment for more difficult provider.• Manage the upset customers conflict and challenging situations.• Worked In a team and self-directed environment• Ensure that all the provider claims must go to correct insurance company and minimizing the denial and maiming the total revenue • Having good knowledge of HCPC code, CPT code and having basics knowledge of medical coding • Complete Revenue Cycle management, Denial management and Eligibility verification knowledge of US healthcare process.