Prasad
Mylaram
Healthcare Operations & Analyst — Optum Global Solutions
Objective
Senior claims associate with 4 years of experience in US healthcare claims processing and adjudication, specializing in end-to-end claims life cycle, payment accuracy, and denial analysis.
Experience
Healthcare Operations & Analyst
Overview of the US healthcare system, including the roles of healthcare providers, payers (insurance companies), and patients.
Focus on the revenue cycle management (RCM), from patient intake to the final payment.
A process of verifying a patient's insurance coverage, confirming benefits, and determining the scope of coverage for specific treatments or services.
Strong analytical skills utilized to assess and evaluate claims for accuracy and completeness.
Experience in maintaining and organizing claim documents and records in compliance with regulatory standards.
Proficient in identifying issues, investigating claims, and resolving discrepancies in a timely manner.
Comprehensive understanding of insurance policies and coverage to accurately adjudicate claims.
Knowledge of industry regulations and guidelines to ensure compliance in claims handling.
Skills
Education
I hereby declare that the above-mentioned information is correct to the best of my knowledge and I bear responsibility for the correctness of the above-mentioned particulars.