Santosh Shet Email & Phone Number

Total I have 9+years of experience in Healthcare Domain with multiple process like Provider Data management Revenue Cycle Management, Acounts recievable etc.Eligibility & Benefit Verification: Check patient’s benefits and insurance status 48 hours prior to date of patient visit with doctors • Charge Posting: Enter charges information like CPTs, ICDs, Modifier, POS, etc in PMS. Also check LMRP for ICDs coverage with CPTs • Claim Management: Generate and submit claim batches to clearing house. Work on claim rejections of clearing house. Print paper claims for secondary and primary insurances. • Payment Posting: Enter payment information from ERAs and Manual EOBs in PMS. Track the underpayments. Manage daily check list of the insurances • Daily Rejections: Work on daily rejection come across while doing payment posting within 48 hours • Account Receivables: Take follow up on Insurances balances every month by generating Insurance balance report from PMS • Patient Statements Verification: Verify each patient statement to check either the patient balance is correct or not • Insurance Credentialing: Individual and Group Provider credentialing with the insurance companies either through online website or paper application. CAQH enrolment for commercial insurance companies. Taking timely follow up of submitted application until it gets approved. • Hospital Appointment Applications: Fill up hospital appointment applications either through online website or paper application. Taking timely follow up of submitted application until it gets approved. • ERA and EFT Enrolments: Fill up ERA and EFT applications for all possible insurances to fasten the cashflow. • Monthly Reporting and Practice Data Analysis: Prepare monthly reports like, Production Analysis, Collection Analysis, Productivity analysis, Production and Collection by Providers, Aging Summary, Aging Details, Procedure analysis, etc.