Open to opportunities

Nick jethava

@nickjethava

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Results-driven Process Associate specializing in Healthcare RCM and Authorization.

India

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What I'm looking for

I am looking for a role that fosters growth, values teamwork, and allows me to optimize healthcare processes.

I am a results-driven Process Associate with over 2.5 years of experience in Revenue Cycle Management (RCM), focusing on medical prior and retrospective authorizations, insurance verification, claims processing, and denial resolution. My proficiency in OncoEMR, PMS, and Centricity, combined with my strong expertise in data analytics and process improvement, has allowed me to streamline workflows and enhance authorization accuracy significantly.

At Ifedora Healthcare, I spearheaded authorization processes for high-priority cases, managing over 100 authorization requests daily with a 99% accuracy rate. I have successfully trained and mentored new team members, optimizing daily performance reports and reducing turnaround times by 30%. My commitment to improving operational efficiency and reducing denial rates has been a driving force in my career, and I am passionate about optimizing RCM operations to drive cost savings and revenue growth.

Experience

Work history, roles, and key accomplishments

Current

Level 2 Process Associate - Authorization

Current

Ifedora Healthcare

Aug 2023 - Present (1 year 11 months)

Spearheaded authorization processes for high-priority cases, including chemotherapy, OBGYN procedures, inpatient and outpatient surgeries, and pain management treatments. Managed over 100 authorization requests daily through various channels, ensuring 99%+ accuracy in processing. Optimized daily authorization performance reports, enhancing operational efficiency and reducing turnaround times by 30

Revenue Cycle Management PMS Data Analysis Process Optimization Team Leadership Denial Management

Junior Executive - Authorization

IGlobal Healthcare

Oct 2022 - Present (2 years 9 months)

Conducted end-to-end quality assurance (QA) and quality control (QC) audits, improving authorization accuracy and reducing errors by 40%. Developed comprehensive authorization tracking systems, streamlining the verification and approval process. Improved authorization processing efficiency, leading to a 20% reduction in claim denials and faster approvals.

Quality Assurance Quality Control Insurance Verification Workflow Optimization Data Entry Reporting

Education

Degrees, certifications, and relevant coursework

Swarnim University

Post Graduate Diploma, Medical Laboratory Technology

Grade: 8.8/10.0

Completed a Post Graduate Diploma in Medical Laboratory Technology. Achieved a CGPA of 8.8/10.0, demonstrating strong academic performance in the field.