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Viresh Choudhary

@vireshchoudhary

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Medical Biller at R1 RCM processing 100+ daily claims and resolving denials, rejections, and appeals.

India

Message

At R1 RCM, I analyze 100+ daily claims for accuracy, completeness, coding, and regulatory compliance. I validate eligibility and claim details, then use EP, SSI, EZ-CAP, and Availity Scrubber to research claims and resolve scrubbing errors.

Previously, I adjudicated professional and institutional claims at Calibrated Healthcare Network and processed US healthcare claims at Capgemini India Pvt. Ltd. My work has included investigating denials and duplicate claims, managing appeals and rebilling, and supporting HIPAA-compliant claims workflows.

Experience

Work history, roles, and key accomplishments

Current

Medical Biller

Current

R1 RCM

Jul 2022 - Present (4 years 4 months)

Analyze 100+ daily claims for accuracy, completeness, proper coding, and regulatory compliance. Process patient demographics and insurance data, validate claim details, and submit clean claims to ensure accelerated payer reimbursement.

SSI EZ CAP Availity Scrubber Claim Scrubbing Denial Management Appeals Eligibility Verification Medical Billing Claims Processing

Current

Medical Biller

Current

R1 RCM

Jul 2022 - Present (4 years 4 months)

SSI EZ CAP Availity Scrubber Claim Validation Denial Management Appeals Rebill Payer Follow Up Regulatory Compliance

Claim Examiner

Calibrated Healthcare Network

Apr 2018 - Jun 2022 (4 years 2 months)

Performed comprehensive claim adjudication across Professional (CMS-1500/837P) and Institutional (UB-04/837I) claim formats. Generated and analyzed operational reports to identify recurring claim discrepancies and reduce error frequencies.

Claim Adjudication CMS 1500 CMS 1500 837P UB 04 837I Institutional Claim Files Report Analysis Inventory Management Root Cause Analysis Query Resolution

Claim Examiner

Calibrated Healthcare Network

Apr 2018 - Jun 2022 (4 years 2 months)

Claims Adjudication CMS 1500 CMS 1500 837P UB 04 837I Institutional Claim Files Report Analysis Inventory Management Root Cause Analysis Claims Investigation

Process Associate

Capgemini India Pvt. Ltd.

Jan 2015 - Jan 2018 (3 years)

Processed US healthcare claims with high accuracy and full compliance with HIPAA and client guidelines. Conducted routine quality audits and provided operational support and workflow training to team members.

U.S. Healthcare Claims HIPAA compliance Quality Audits Operational Support Workflow Training

Process Associate

Capgemini India Pvt. Ltd.

Jan 2015 - Jan 2018 (3 years)

Processed US healthcare claims with high accuracy and full compliance with HIPAA and client guidelines. Conducted routine quality audits and provided operational support, subject-matter guidance, and workflow training to team members.

Healthcare Claims Processing HIPAA compliance Quality Audits Operational Support Workflow Training