Asadullah Khan Email & Phone Number

Bengaluru, Karnataka, India

• Demonstrated hands-on experience with the SFDC web application for Case assignment, analyzing benefit requests according to the Client Requirement Document (CRD), and processing them accurately.
• Gained practical experience in creating bars, processing claims, and testing claims within the RxClaim application.
• Worked on existing plan codes in line with the client's requirements for Cost Saver, WM-Bundle, MyPBM, Drug Coverage, and Accumulation projects.
• Ensured timely communication of any issues and provided necessary information to complete case requests.
• Developed and managed client-specific implementation plans and processes according to departmental guidelines.
• Utilized hands-on experience in running pre-query, plan query, post-query from the Sequel web application system to gather necessary information for implementing plan requests.

Mysore, Karnataka, India

Aetna/CVS Healthcare Plan Set Up (PSU)Aetna Middle Market PCC (Plan Coordination Consultant)Code Plan sponsor information, Medical benefits, and Vision benefits into the Policy entry reporting system (PE/RS)Assist with creating account structureIdentify solid Benefit Identification code (BIC)-Sequences and Network IDsProvisions and Line values that appear.

Mysore, Karnataka, India

Aetna/CVS healthcare Complaints, Grievances and Appeals (CGA)This role involves extensive healthcare/medical documents analysis,analytically strong in interpreting the healthcare verbiages.Good knowledge on US Healthcare payer domain. Having knowledge in Complaints, Grievances and appeals experience.Subject expert in US healthcare payer claim adjudication.

Mysore, Karnataka, India

Perform outbound calls to insurance companies to collection outstanding AR.Working on Denials, Rejection, Request for additional information.Strong RCM knowledge & possess good knowledge of HIPPA, CPT codes, Appeals & denial management.

Mysuru, Karnataka, India

Immense expertise in supplying & trading of Auto electrical spare parts - two wheeler, head lamp relays, meter bulbs etc.