Christopher Samuel Email & Phone Number

Bengaluru, Karnataka, India

Bengaluru, Karnataka, India

Chennai, Tamil Nadu, India

Chennai, Tamil Nadu, India

 Playing a key role as a member of the Payment Integrity Compass team, maintaining the responsibility for the analysis, modeling, interpretation and loading of healthcare/managed care insurance contracts in the Payment Integrity Compass application Handling the large volume of data (claims) that comes in the form of contracts made between the large hospitals and the various payers, interpreting the data and making decisions which would predict the future of the revenue collected for a particular time period Reaching out to the development team for possible enhancements to our product, predicting the upcoming re-imbursement changes from the payer end and equipping our product before the payer starts paying the new way Communication plays a vital role and we communicate with various hospitals (our members) on a regular basis through Salesforce, e-mail communication and via phone calls Mastering the functionality of the business intelligence tool and improvise to expertise in the product terrain to perform the responsibility of the role Handling Status calls, Defect call and walkthrough meetings with onshore leads/Clients

Chennai, Tamil Nadu, India

 Handled the large volume of data (claims) that comes into the given tier/queue, interpreted the data and making decisions which would decide the future of the claims  Identified and recognized opportunities and resolved problems related to EDI Prioritized customer requirements and maintained continuous improvement through customer feedback Submission of claims successfully to the payer is our ultimate goal within a given time frame (TAT of 3 Business days from the time the claim was created). Overcoming various hurdles with the payers and identifying and mapping the rejected claims appropriately  Coordinated with developers to help them understand the business purposes and have the functionalities implemented Built new connection with the payers, Increasing EDI Rate, Automation of work, etc.  Trained and mentored the new hires

 Played vital role in denial management & EDI Rejections of accounts by performing pre-call, on-call and post-call analysis. These call analysis helps to bring about a resolution in the claims thereby adding value to role in the organization Accountable for documenting process metrics for the process Investigated account discrepancies and resolved customer inquiries

Bachelor Of Science (B.Sc.), Computer Science

Education record