Rukmini Hatkar Email & Phone Number

To adjudicate the claims and take necessary action i.e. to pay, deny, or pend based on the received information.Verifying details of members and providers in all aspects. Handling the complete process related to payments to members and providers.Handle invalid Claims, Adjudication claims, and follow-up claims for statusWorking on US Healthcare services such as charge entry, and payment posting. Processing both Medical and Hospital claims through.Processed claim forms, and… Show more To adjudicate the claims and take necessary action i.e. to pay, deny, or pend based on the received information.Verifying details of members and providers in all aspects. Handling the complete process related to payments to members and providers.Handle invalid Claims, Adjudication claims, and follow-up claims for statusWorking on US Healthcare services such as charge entry, and payment posting. Processing both Medical and Hospital claims through.Processed claim forms, and adjudicated for the provision of deductibles, co-pays, co-insurance maximums, and provider settlements.Complied with all judgmental policies and processes to ensure appropriate claim payments.Provided excellent customer service to all providers, members, insurance companies, and billing departments.Researched and analyzed claim overpayments and funds requirements.Ensured to take minimum assistance for processing complex claims.Performed and managed routine follow-up activitiesHandled team responsibilities and solve their queries as a part of daily operations.Handled stressful situations successfully by maintaining a high standard of quality and timelines.Medicare and Commercial overall audits as daily basis.Having knowledge of CPT codes, Revenue Codes, EOB, HIPPA rules, and Medicare claims.Reporting to the Team Lead about the daily accuracy and production Show less

Knowledge of medical terminology in relation to diagnoses and proceduresEnrollment issues/quires.Application maintenance and backup.Working on Customer support Emails along with reports.Ability to maintain the records & review for the good Quality.Deep knowledge of the health claims processing technicalities.Responsible to provide support to new joiners/fresher’s and create ramp-up plan on the quality