Gauri Shankar Pathak

Experience

• 

  Justdial

  Dec 2015 - Dec 2018

  Customer Service Specialist

  Information retrieval - Team customer and client escalation

• 

  Pacific access healthcare

  Jan 2018 - Apr 2019

  Claims Analyst

  01.Followups, (Through calling Insurance, website,emails,fax status check up requests).02. Payment confirmation - Helped a team to find the right amount and encashment date of checks.03 Physician Billing, charge entry of physician Bills,followups, Appealing,Denial management

• 

  Vericle - Health IT and RCM services

  Oct 2019 - Sept 2021

  Monitors Quality Assurance related to job functions per team, i.e. billing, customer service, follow-up, collections, scanning.• Knowledge of business office applications and systems.• Detects and corrects edits claims prior to submission/transmission of claims, and verifies confirmation received on transmitted claims.• Apply coding conventions in order to resolve claim issues and discrepancies with medical necessity.• Responds to customer service phone calls, documents actions and findings.• Makes calls to responsible parties to determine ability to pay accounts, making financial arrangements when appropriate.• Establishes payment arrangements or offers financial assistance, such as charity, Medicaid, government assistance. Completes assistance application and reviews with established guidelines to approve or disapprove.• Process daily electronic payer rejections.• Post payments, research credit balances, refunds, and process in a timely manner.• Performs follow up, review, and, managing A/R at assigned dunning levels.• Researches managed care contracts fee schedules to ensure correct payment and contractuals are taken, effecting account resolution. Show less

  • Enrollment Specialist

    Jun 2021 - Sept 2021

  • Customer Relationship Management Specialist

    Mar 2021 - Jun 2021

  • Senior Claims Specialist

    Oct 2019 - Mar 2021
• 

  Aprima Medical Software, Inc.

  Sept 2021 - Jan 2022

  Senior Claims Analyst
• 

  HYBRID BACKOFFICE

  Jan 2022 - now

  Senior Operations Specialist

  I am a Senior Operations Analyst in the RCM (Revenue Cycle Management) Billing & AR Department, - QA( Quality analyst)