Ramoo Singh

Experience

• 

  IBM Daksh

  May 2010 - Apr 2012

  Medical Claims Examiner

  • Dealing with Claims Processing/adjudication (i.e. Medical and Hospital claims) for client Aetna.• Audited the new Joining agent’s claims before releasing the claims as a second look.• Analyzing the Root cause of errors and action plan to minimize those errors in team.• Providing process training to the new hires.

• 

  UnitedHealth Group

  Apr 2012 - Aug 2015

  Senior Associate

  • Dealing with provider updates in contractual and demographics.• Providing training to new hires and audit/ reverse audits.• Handling daily/ weekly call, VOC call with client and reporting to Manager and Client.• Reporting on excel for the process through BO (Business Object).

• 

  EXL Service.com

  Aug 2015 - Oct 2017

  Medial coder, Medical/Facility claims

  • Analyze and research for overpayment to minimize cost to Aetna following by medical coding and billing and other guidelines.• Rework on incorrect claims, Reporting and mentoring/training support to new joiners.• Project/Policy development followed by Medical coding and submission for client approval.• Denial and dispute coding, adjustment, CPT verification and appeal management.• Medical coding, Surgery, IVR, Radiology and ICD-10 CM etc.