Niraj Roy Email & Phone Number

India

Navi Mumbai, Maharashtra, India

1. Interacted with internal customers to understand business needs and translateinto requirements and project scope.2. Supported software development projects by defining clear requirements andeffectively communicating them to technical teams.3. Optimized workflow processes to enhance overall productivity and achieveoperational excellence.4. Collaborated with stakeholders to define project objectives and criteria.Increased efficiency in resource allocation by conducting detailed businessrequirements analysis.5. Collaborated closely with stakeholders to identify opportunities for processimprovements and drive continuous innovation in the organization.6. Performed gap analysis to identify areas of improvement.Conducted interviews with key business users to collect information onbusiness processes and user requirements.7. Performed gap analysis between existing systems or processes and desiredstate, identifying areas for improvement or enhancement.8. Streamlined project management with effective communication andcollaboration across cross-functional teams.9. Improved business processes by analyzing current practices andrecommending optimization strategies.10. Applied honed problem-solving skills to analyze and resolve issues impactingbusiness operations and goal achievement.

India

1. Serve as the primary point of contact for clients, addressing inquiries, troubleshooting issues, and providing timely resolutions.2. Worked closely with development teams to ensure accurate interpretation of requirements.3. Develop strong relationships with clients, understanding their unique business needs and objectives.4. Participated in user acceptance testing (UAT) and provided training and support during product releases.5. Performed gap analysis between existing systems or processes and desired state, identifying areas for improvement or enhancement.6. Streamlined project management with effective communication and collaboration across cross-functional teams.7. Improved business processes by analyzing current practices and recommending optimization strategies.8. Assisted in the development of training materials and user documentation.9. Product support for Clearing House (EDI) and Billing Software (PMS).10. Assisted in the development of data-driven reports and dashboards for internal and external stakeholders.

Noida, Uttar Pradesh

1. Provided detailed reports on quality metrics to senior management, enabling informed decision-making regarding process improvements.2. Developed training materials, SOPs and work instructions to supplement new team member onboarding.3. Monitored KPIs to proactively address bottlenecks and quality issues.4. Conducted regular audits of billing records to identify trends or issues that may impact financial performance or compliance.5. Championed a proactive approach to problem-solving within the team, fostering an environment of collaboration and innovation.6. Conducted thorough root cause analyses on recurring defects, resulting in the implementation of effective corrective actions.

Gurugram, Haryana, India

1. Enhanced revenue collections by efficiently managing accounts receivable and following up on outstanding claims.2. Ensured compliance with federal regulations and payer guidelines, maintaining updated knowledge of industry changes.3. Optimized payment posting processes for faster reimbursement, tracking payments from various sources including insurance companies, Medicare, Medicaid, and private payers.4. Reduced claim denials by accurately coding diagnoses and procedures using ICD-10, CPT, and HCPCS codes.5. Implemented effective appeals strategies for denied claims, resulting in increased revenue recovery rates.

Faridabad, Haryana, India

1. Lead the organization's revenue cycle management strategy, overseeing a team of billing professionals.2. Accurately coded and billed medical procedures, diagnoses, and services using ICD-10, CPT, and HCPCS codes.3. Assisted in the verification of patient insurance eligibility and benefits.4. Processed insurance claims and followed up on claim denials and underpayments.5. Maintained electronic health records (EHR) and billing software.6. worked on clearing house to reduce the Claim Rejections.

Gurugram, Haryana, India

1. Develop and execute policies and procedures to optimize the billing and coding process.2. Accurately coded and billed medical procedures, diagnoses, and services using ICD-10, CPT, and HCPCS codes.3. Processed insurance claims and followed up on claim denials and underpayments.4. Collaborated with providers and patients to resolve billing inquiries and discrepancies.

Noida, Uttar Pradesh, India

1. Evaluate insurance policies and contracts to determine coverage, limitations, and exclusions.2. Assess risk factors and analyze data to make informed underwriting decisions.3. Review and analyze claims records, identifying trends and patterns to improve risk assessment.4. Assist in the development of new insurance products and policy offerings.5. Conducted data analysis and created reports to support underwriting decisions.6. Responded to client inquiries and assisted with policy-related questions.7. Assisted in compliance audits and ensured adherence to insurance regulations.8. Participated in training programs to enhance insurance knowledge and analytical skills