BHUVIJA NALLA

• Managed a daily workload of 60+ complex insurance claims while consistently meeting productivity and quality targets for U.S. healthcare providers, including Holston Medical Group and Duke Hospitals.
• Performed insurance follow-up through payer portals and outbound calls to resolve outstanding claims efficiently.
• Investigated denied, rejected, and underpaid claims by identifying root causes and implementing corrective actions.
• Successfully prepared and submitted appeals that improved reimbursement rates and reduced outstanding accounts receivable with supporting medical documentation, significantly improving reimbursement rates.
• Reduced average claim resolution turnaround time to 48 hours through proactive follow-up and effective prioritization.
• Conducted denial trend analysis and collaborated with coding and billing teams to reduce recurring claim issues.
• Reviewed Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERA) to verify payment accuracy.
• Performed aging analysis and receivable reconciliations to improve collections and reduce outstanding balances.
• Generated receivable reports and monitored key performance indicators to support financial decision-making.
• Maintained HIPAA compliance while handling confidential patient and financial information.
• Communicated daily with U.S. insurance representatives, provider offices, and billing teams to resolve claim-related issues.
• Received client appreciation for improving credentialing processes and reducing claim resolution timelines.
• Awarded Employee of the Month for clearing backlogs and consistently exceeding productivity goals.
• Received the Best Revenue Collection Award for outstanding collection performance and project delivery.

Key Responsibilities

• Managed accounts receivable and insurance follow-up for multiple U.S. healthcare providers.
• Resolved coding denials, eligibility issues, authorization denials, and billing discrepancies.
• Contacted insurance companies to determine claim status and expedite payment processing.
• Reviewed EOBs and payment postings to ensure accurate reimbursement and account reconciliation.
• Monitored daily collections and maintained detailed receivable tracking reports.
• Performed monthly account reconciliations and analyzed aging reports to prioritize overdue accounts.
• Coordinated with billing and coding teams to prepare corrected claims and resubmit denied claims.
• Maintained accurate documentation of payer communications and account activities.
• Assisted in resolving complex payment disputes and escalated claims.
• Ensured compliance with HIPAA regulations, payer guidelines, and internal quality standards.
• Supported continuous process improvement initiatives to increase collection efficiency and reduce denial rates.
• Delivered excellent customer service while protecting organizational interests and maintaining professional relationships with clients and insurance representatives.