Deepa Sampath

At Sagility Health Care (Formerly Hinduja Global Solutions), I audited physician claims for compliance with quality and billing standards, working with CMS-1500 claim forms and physician claim workflows.

I reviewed medical records and Explanation of Benefits (EOBs) to validate diagnosis and procedure coding, verifying CPT and diagnosis codes in collaboration with Cotiviti.

I processed claim adjudication, claims reprocessing, and CRM appeals for US healthcare clients. I also investigated provider and insurance data for potential fraud, waste, and abuse, and followed up on denied claims with insurance companies and provider offices.

I created Excel pivot tables and quality reports to track team performance and accuracy, maintained 100% quality, and received multiple performance awards. At Coforge Private Limited, I conducted quality audits for US mortgage operations and reviewed documentation for accuracy and compliance.