Sumitha S Email & Phone Number

I have 4 years 10 months of strong experience in US Healthcare working as Senior process Consultant, during this period i have gained in the areas of medical claims and claim validation, claim processing and claim adjudication which was followed by timely and effective client support, include the appropriate escalation of client complaints. creates the framework and business acumen necessary to serve the client, processing the different forms of claims namely CMS-1500, UB-04, Medical, hospital Dental and others forms, handling the complex queries of Bill Review such as KFI, Audit And Re-Evaluation, Denials claims send back with the EOBs (Explanation of benefits) , acquiring the knowledge of related areas of the project to be more productive, understanding analyzing and resolving the medical queries, i have the experiences in both sides like payer side as well Provider side (Provider Data Management)knowing about PCP assignment, GSI /GMI, Networks like OAP, PPO, HMO An Flexible products, Networks, Copay, co-insurance and Deductible ,and also having the experience in Add the provider, term the provider and Update the provider details by using the CPF, HCPM In Citrix software

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  Kuvempu University

  Accounting And Finance