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Smita Gade is listed as U.S Healthcare Domain,Claim Analyst as Power BI and SQL at Evolent, based in Pune, Maharashtra, India. AeroLeads shows a matched LinkedIn profile for Smita Gade.
Smita Gade previously worked as U.S Healthcare Domain,Claim analyst as certified Microsoft Power BI and SQL at Evolent and senior representative operations at Concentrix. Smita Gade holds M.C.A (Sci), Computer Science, Distinction from Savitribai Phule Pune University.
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Total 7.5 years of experience in US Healthcare Over 2 years of experience as Power Bi developer on development of reports and Dashboards using Power BI. Highly skilled in Document data sources, data transformations, and report specifications.Design and develop data models to support reporting requirements.Extract data from various sources, including databases, Excel, and csv files.Data verification and claims adjustment Worked on various Queues like eligibility. psdp. sql. pcp for different clients. Skilled in clinical domain , Electronic medical records (EMR),provider appeal intake process. Excellent skills compiling, coding, categorizing and auditing information to process claims and appeals.
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Pune, Maharashtra, India
*Currently working at Evolent Health International Private Limited.*Claims Analyst with Over 2 years of experience as Power Bi developer on development of reports and Dashboards using Power BI. *Highly skilled in Design and develop data models to support reporting requirements.
Pune, Maharashtra, India
*Proficient level adjudicator providing strong analytical skills to review claim rules and workflows and Responsible for adjudicating claims .*Responsible for handle COVID19 project Claims, flag claims and Commercial claims.*Ability to Process high dollar claims and create inquiries if claim paid/reject incorrectly to receive/give refunds.*Effective communications with supervisors regarding claim issues including claim adjudication, over payments, underpayments or any other… Show more *Proficient level adjudicator providing strong analytical skills to review claim rules and workflows and Responsible for adjudicating claims .*Responsible for handle COVID19 project Claims, flag claims and Commercial claims.*Ability to Process high dollar claims and create inquiries if claim paid/reject incorrectly to receive/give refunds.*Effective communications with supervisors regarding claim issues including claim adjudication, over payments, underpayments or any other irregularities.*Meets all production, quality standards and attends all required training courses and Support to the new hires while they Handling claims Show less
Pune, Maharashtra, India
*Maintain confidentiality of all information, policies and procedures as required by the HIPAA Protocols.*Knowledge of policy concepts like Deductible, Coinsurance, Co-pay, Out of pocket.*Reviews, evaluate and make appropriate approval or denial decisions on claims.*Ensured to take the corrective action steps using enrolment, benefit and historical claim processing information and inquiries.*Handled Member, provider, Managecare, duplicate,benefits and pricing related suspensions.
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Smita Gade works for Evolent.
Smita Gade is listed as U.S Healthcare Domain,Claim Analyst as Power BI and SQL at Evolent.
Smita Gade is based in Pune, Maharashtra, India while working with Evolent.
Smita Gade has worked for Evolent and Concentrix.
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Smita Gade holds M.C.A (Sci), Computer Science, Distinction from Savitribai Phule Pune University.
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