Arvind Kumar Yadav Email & Phone Number

Gurugram, Hr, In

Gurugram, Haryana, India

Noida, Uttar Pradesh, India

Reviewing or auditing the payment accuracy of the claims of specific Services rendered to Member by following business guidelines as instructed by the Auditing System, which is more of a combination of Claims Adjudication Process and Smart Auditing Process. The Audit system pulls out claims based out of CMS guidance and compliance to payment. Our work lies in adjudicating the payment accuracy complying with CMS policies or not and thus savings huge dollar amounts that would have been paid out incorrectly.• Worked on Physician and Hospital claims with data entry,provider selecttion and payment accuracy. • Check the denials and payment of the claim , incorrect denials re-entered for correct payment and overpaid claims are repriced for correct payment.