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Vidya Vijayakumar Nair

@vidyavijayakumarnair

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Experienced Senior Medical Claims Adjuster with proven negotiation skills.

Sweden

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What I'm looking for

I am looking for a role that offers growth opportunities and values collaboration.

I am a Senior Medical Claims Adjuster with over three years of experience at HCSC Group Claims - BCBS of Illinois, specializing in the examination of health-related claims. My expertise in ICD-10 coding systems and CPT code sets has enabled me to investigate and evaluate over 3000 health insurance claims, ensuring accurate coverage and liability determinations. I take pride in my ability to maintain a 99% accuracy rate in documenting all claim details and decision processes, which has significantly contributed to the efficiency of my team.

Throughout my career, I have successfully negotiated settlements with an average of 50 claimants, attorneys, and insurers each quarter, all while adhering to established authority limits. My strong teaching skills and collaborative approach have enhanced internal partnerships, resulting in a 20% increase in timely and fair claim resolutions. I am committed to delivering high-quality results in fast-paced environments and have played a key role in adopting new insurance claims software, which decreased processing time by 15%.

Experience

Work history, roles, and key accomplishments

Senior Medical Claims Adjuster

HCSC Group Claims - BCBS of Illinois

Nov 2022 - Oct 2023 (11 months)

Experienced claims adjuster with three years of experience in examining health-related claims. Investigated and evaluated over 3000 health insurance claims, maintaining a 99% accuracy rate. Proven ability to negotiate settlements and enhance collaboration with internal departments, resulting in a 20% increase in timely claim resolutions.

HCPCS Negotiation Communication Process Improvement Team Collaboration Customer Satisfaction

Healthcare Claims Expert

Cognizant Technology Solutions

Jun 2021 - Oct 2022 (1 year 4 months)

Assisted senior claims adjusters in processing an average of 300 medical insurance claims monthly. Played a key role in adopting new insurance claims software, decreasing processing time by 15%. Achieved a 98% customer satisfaction rating through effective communication.

CPT HCPCS Customer Satisfaction Communication Teamwork

Education

Degrees, certifications, and relevant coursework

Udemy

Certification, Medical Coding

2022 -

Currently enrolled in a course focusing on ICD 10 & 11 Medical Coding and Billing, enhancing skills necessary for accurate healthcare claims processing.

Udemy

Master of Science, Biotechnology

2023 -

Currently pursuing a Master of Science in Biotechnology, expanding knowledge in advanced biotechnological applications and research methodologies.

PSG College of Arts and Science

Bachelor of Science, Biotechnology

2019 - 2021

Studied Biotechnology, focusing on the application of biological processes in various industries. Developed a strong foundation in the principles of biotechnology and its relevance in healthcare.

Nehru Arts and Science College

Bachelor of Science, Biotechnology

2016 - 2019

Pursued a Bachelor of Science degree, gaining knowledge in various scientific disciplines and enhancing analytical skills. Engaged in practical laboratory work and research projects.