ishrath fatima

Processed US-based medical claims including payments and denials and performed pricing/allowed-amount lookups from Network X Price, GPOO and FileNet for pharmacy and specialty drug claims. Trained new joiners, produced end-of-day claim reports, and supported billing of professional claims using Collaborate and Epic while following HIPAA requirements.

Adjudicated inpatient, outpatient and skilled nursing facility claims including COB, Medicare, Medicaid, adjustments and corrected/void claims; managed prompt-pay and highly aged claims. Worked restricted queues and ITS claims (Blue2) and used CIW, Reflection Workspace, M360, ACMP, WCF and GPOO to resolve complex billing issues.

Managed refund operations and investigated customer issues via email, recording payments, account information and call logs into systems while responding to customer requests. Supported domestic voice and non-voice processes, maintained documentation of medical records and coordinated escalations to meet SLAs.

Completed Bachelor of Commerce at OUCW Degree Commerce College, graduating in 2014.

Completed secondary education at Indo-American School, Hyderabad in 2012 under the Board of Secondary Education.

Completed Intermediate studies at Sri Gayatri Junior College in Hyderabad.