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MJ@mohdehteshamuddinjam
Claims Associate with expertise in US healthcare claims processing.
IndiaI am a dedicated Claims Associate with over five years of experience in the healthcare industry, specializing in claims adjudication and process improvement. My journey began with a strong academic foundation in computers, which I have effectively leveraged in my professional roles. At Carelon Global Solutions, I processed complex claims while ensuring compliance with Medicare, Medicaid, and HIPAA regulations, consistently exceeding performance goals.
Throughout my career, I have developed a keen understanding of U.S. healthcare insurance products and have been recognized for my contributions to team performance and quality. My ability to analyze and resolve claims efficiently has been instrumental in maintaining high levels of provider satisfaction. I thrive in dynamic environments where I can utilize my analytical skills and attention to detail to drive organizational growth.
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Work history, roles, and key accomplishments
Carelon Global Solution
Sep 2019 - Present (6 years 2 months)
Processed Institutional (UB-04) and Professional (CMS-1500) claims across ITS and NON-ITS, ensuring compliance with Medicare, Medicaid, and HIPAA regulations. Achieved targets across accuracy, efficiency, and provider satisfaction, consistently exceeding performance goals.
Optum Global Solutions
Jul 2018 - Present (7 years 4 months)
Created Summary of Benefits and Coverage (SBC) documents as per ACA compliance guidelines for enrollees. Analyzed cost-sharing components and ensured 100% adherence to TAT goals.
First American India Pvt Ltd
Mar 2017 - Present (8 years 8 months)
Performed entry and verification of real estate documents for mortgage and title insurance processing. Conducted quality checks and error rectification to ensure compliance with accuracy and turnaround standards.
Degrees, certifications, and relevant coursework
OUBachelor of Commerce, Computers
2011 - 2015
Completed a Bachelor of Commerce with a specialization in Computers. Gained foundational knowledge in business principles and computer applications.
Intermediate, General Studies
2009 - 2011
Completed Intermediate education from the Board of Intermediate. Focused on core subjects to build a strong academic foundation.
SSC, General Studies
2008 - 2009
Completed Secondary School Certificate (SSC) education. Developed fundamental academic skills and knowledge across various subjects.
Software and tools used professionally
IndiaYou can contact Mohd Ehtesham and 90k+ other talented remote workers on Himalayas.
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