Anisha Ghosal
@anishaghosal
Senior RCM backend processing professional improving documentation accuracy and denial prevention across healthcare claims.
IndiaWhat I'm looking for
I’m a Senior Process Executive in RCM Backend Processing at Cognizant, with 5+ years of experience across US healthcare RCM (Insurance & AR Management) and UK insurance (BFSI) operations. I focus on patient data verification, CPT cross-checking, and denial-prevention quality checks, maintaining strong documentation accuracy before coding handoff.
In my current role, I verify registration, charge entry, and superbill data across 1000 records per day, cross-validate patient identity details against medical records and prescriptions, and flag non-compliant orders to reduce claim denials. I also own client communication via JIRA for discrepancy tickets, compile structured datasets for coding teams, and audit billed charges for mismatches—so quality, turnaround, and AR targets stay on track.
Experience
Work history, roles, and key accomplishments
Verify patient registration, charge entry, and superbill data; cross-check patient identity and validate CPT codes and physician signatures to prevent claim denials. Compile verified datasets in Excel and manage client documentation queries via JIRA while auditing billed charges before submission.
Verified customer and policy data across departmental systems while maintaining data privacy and compliance standards. Audited cases against quality checkpoints with root cause analysis, standardized reporting, and processed policy discounts and issuance per SOP.
Handled 50+ inbound calls and 15+ customer cases daily, resolving conflicts and coordinating with hotel aggregators on service issues. Achieved 85% average CSAT and trained new associates on data entry and interaction logging.
Education
Degrees, certifications, and relevant coursework
IMT Ghaziabad
Post Graduate Program in Management, Management (HR Specialization)
2021 - 2022
Post Graduate Program in Management with an HR specialization, covering topics such as job analysis, workforce planning, performance and retention management, and compensation structure.
Jamshedpur Women's College
Bachelor of Commerce (Honors), Commerce
2016 - 2019
B.Com. (Hons.) degree covering undergraduate commerce studies at Jamshedpur Women's College, affiliated with Kolhan University.
Tech stack
Software and tools used professionally
Availability
Location
IndiaAuthorized to work in
Job categories
Interested in hiring Anisha?
You can contact Anisha and 90k+ other talented remote workers on Himalayas.
Message AnishaGet matched with your dream remote job
Sign up now and join over 250,000+ remote workers who receive personalized job alerts, curated job matches, and more for free!
