EPIC
BHRANTI PATEL
Little Elm,TX
Summary
Professional with extensive experience in claim investigations, resolving complex billing discrepancies, and optimizing operational efficiency. Expertise in credit control, debt recovery, and effective communication, with a proven track record of success. Skilled in claim trend analysis, process improvement, and project management, with meticulous attention to detail. Proficient in Microsoft Office, data analysis, and team leadership.
Overview
5
5
years of professional experience
Work History
Account Adjuster - Revenue Cycle Credit Management
UT Southwestern Medical Center
Dallas, TX
05.2023 - Current
- Conducts thorough reviews of medical claims to identify and rectify overpayments, billing inaccuracies, and reimbursement discrepancies, ensuring compliance with organizational standards and regulatory requirements.
- Accurately processes refunds and recoupment requests to insurance companies, promptly addressing overpayments or errors while adhering to established protocols and maintaining meticulous records.
- Investigates complex billing errors, coding discrepancies, and claim-related issues, obtaining necessary approvals for adjustments, and posting adjustments accordingly.
- Verifies insurance eligibility through provider portals, confirming correct primary and secondary coverages to prevent claim overpayments, and optimize reimbursement accuracy.
- Analyzes trends in insurance claim recoupments and adjustments, proactively identifying opportunities for process improvement, and implementing strategies to enhance efficiency and accuracy.
Medical Collections Specialist
BayMark Health Services
Dallas, TX
12.2021 - 05.2023
- Investigated and analyzed trends in claim denials, rejections, and delayed payments, effectively identifying underlying issues and implementing corrective measures to enhance payment processes
- Collaborated with insurance companies to resolve disputes and denials, submitting additional documentation or medical records as required to support the successful resolution of claims
- Identified and rectified discrepancies in payment allocations, coding errors, and claim information, ensuring accurate alignment of medical codes and modifiers with the services rendered
- Managed the preparation and submission of appeals for denied claims, providing comprehensive documentation to support appeals and closely monitoring their progress until resolution
- Oversaw accounts receivable aging reports, prioritizing the resolution of aging claims and developing strategies to reduce outstanding balances, while maintaining detailed records of all interactions and collection efforts
Medical Billing and Collections Specialist
Diya Care Inc.
Edison, NJ
03.2020 - 10.2021
- Verified and updated patient demographics and insurance information, ensuring accurate eligibility and benefit confirmation to facilitate smooth claim processing and minimize rejections
- Submitted medical insurance claims electronically, adhering to all documentation requirements and industry standards, while ensuring timely and accurate claim submissions
- Reconciled insurance payments against billed amounts, meticulously identifying discrepancies, and conducted consistent follow-ups on outstanding claims to secure prompt reimbursement
- Investigated and resolved claim denials by analyzing root causes, resubmitting corrected claims, and taking proactive measures to prevent recurring issues, thereby optimizing claim acceptance rates
- Monitored accounts receivable aging reports, prioritizing the resolution of aging claims, and generated detailed performance reports to provide management with actionable insights on billing and collections strategies
Office Administrative Assistant
Krishna Enterprise
Surat, India
02.2017 - 05.2019
- Responded to inquiries from callers, providing accurate information and ensuring a positive and efficient communication experience for clients and stakeholders
- Managed office supplies inventory by regularly monitoring stock levels, placing timely orders, and ensuring that all necessary materials were readily available to support smooth office operations
- Developed and maintained detailed spreadsheets and databases to track, analyze, and report on performance and sales data, facilitating informed decision-making by management
- Managed accounts payable and receivable, accurately recording expenses, maintaining comprehensive accounting records, and updating employee files with critical details such as address changes and salary adjustments
Academic Assistant
Jet Air Academy
Ahmedabad, India
01.2015 - 10.2016
- Addressed and resolved student inquiries related to curriculum and course prerequisites, providing clear guidance and support to ensure academic success and satisfaction
- Coordinated follow-up initiatives and outreach efforts for at-risk students, diligently monitoring their academic progress and implementing strategies to support their educational journey
- Maintained and updated the student database, managing electronic records with precision, while also handling financial documentation, including expense reports and invoices, to ensure accurate record-keeping and compliance
Education
Associate of Applied Business - Fashion and Fabric Consultation
Amor Design Institute
Ahmedabad, Gujarat, India05.2014
Bachelor of Business Administration - Accounting and Finance
Swami Sahajanand College of Commerce & Management
Bhavnagar, Gujarat, India08.2011
Skills
- Credit Control
- Debt Recovery
- Problem Resolution
- Process Improvement
- Regulatory Compliance
- Time Management
- Detail Orientated
- Conflict Resolution
- Refund Management
- Communication Skills
- Microsoft Office
- Appeals Submission
- Trend Analysis
- Documentation Management
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimeWork Location
RemoteHybridImportant To Me
Career advancementWork-life balanceCompany CultureHealthcare benefitsWork from home optionPaid time offTeam Building / Company RetreatsPaid sick leave401k matchStock Options / Equity / Profit Sharing4-day work weekPersonal development programsFlexible work hoursQuote
Every problem is a gift—without problems we would not grow.
Tony Robbins
Software
APRIMA
Languages
Gujarati
Native language
English
Advanced (C1)
C1
Hindi
Upper Intermediate (B2)
B2
Gujarati
Advanced (C1)
C1
Interests
Music
Travelling
Timeline
Account Adjuster - Revenue Cycle Credit Management
UT Southwestern Medical Center
05.2023 - Current
Medical Collections Specialist
BayMark Health Services
12.2021 - 05.2023
Medical Billing and Collections Specialist
Diya Care Inc.
03.2020 - 10.2021
Office Administrative Assistant
Krishna Enterprise
02.2017 - 05.2019
Academic Assistant
Jet Air Academy
01.2015 - 10.2016
Associate of Applied Business - Fashion and Fabric Consultation
Amor Design Institute
Bachelor of Business Administration - Accounting and Finance
Swami Sahajanand College of Commerce & Management
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