Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Haritha Bussu

Madison,AL

Summary

Enrollment Specialist with 10 years of
experience in customer service,
enrollment processes, and data entry.
Experienced in system navigation,
database maintenance, and report
generation.

Overview

9
9
years of professional experience
1
1
Certification

Work History

Health Care & Insurance Operations Senior Market

NTT Data
08.2023 - Current
  • Resolved complex claims issues promptly, demonstrating excellent problem-solving skills and attention to detail.
  • Maintained strict adherence to regulatory guidelines, ensuring compliance and mitigating risks.
  • Implemented effective communication strategies within the team, promoting collaboration and information sharing across departments.
  • Conducted thorough research on insurance policies to provide accurate information and guidance to clients.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Assisted with employee training initiatives, sharing knowledge on processes and systems for a more efficient workforce.
  • Systems used to process are Facets ,DPBMS, sales force
  • Modified, updated and processed existing policies.
  • Knowledge of medicaid & medicare

Managing Director operations

Rocket city Learning Center
01.2021 - Current
  • Responsible for planning, organizing, and coordinating the daily professional operations and training & supervising staff
  • Manage Billing & invoicing
  • Attend network events and advertise the benefits of getting tutored at the learning center
  • Collect and analyze call-center statistics (sales and customer service metrics etc
  • Enjoy working in a busy & varied environment
  • Take up teaching as & when required.

Medical Billing and Office Administration

Happi Urgent Care Huntsville AL
06.2018 - 10.2020
  • Verified insurance coverage and assisted the billing department with processing claims
  • Answered multi-line phone system and directed calls to the appropriate party
  • Greeted patients upon arrival and provided necessary paperwork or other information
  • Scheduled and confirmed appointments
  • Evaluated payments/denials received for correctness
  • Checked eligibility and benefit verification
  • Obtained referrals and pre-authorizations as required for procedures
  • Adhered to regulatory/payor guidelines and policies & procedures
  • Reviewed patient bills for accuracy and completeness and obtain any missing information
  • Prepared, reviewed, and transmitted claims using billing software, including electronic and paper claim processing
  • Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid
  • Follow up on unpaid claims within standard billing cycle timeframe
  • Called insurance companies regarding any discrepancy in payments if necessary
  • Reviewed accounts for insurance or patient follow up
  • Researched and appealed denied claims
  • Updated cash spreadsheet, runs collection reports
  • Handled patient or insurance telephone inquiries pertaining to assigned accounts
  • Applied ICD-10 coding under supervisor
  • Used tools to convert ICD-9 codes.

Department Manager

Walmart - Madison, AL
08.2015 - 01.2020
  • Recruiting, interviewing, and orienting new staff members
  • Setting strategic long and short-term departmental goals and evaluating outcomes
  • Motivating and inspiring staff and facilitating personal growth
  • Ensuring high levels of productivity are maintained
  • Ensuring the highest levels of quality are met
  • Communicating job expectations to staff
  • Conducting training and seminars for continued skills improvement
  • Fostering a productive working environment.

Education

Bachelors in Commerce -

Osmania University
06.1993

Skills

  • Claims Investigation
  • HIPAA Compliance
  • Healthcare regulations
  • Workflow Optimization
  • Insurance compliance
  • Customer Service
  • Organizing and Prioritizing Work
  • Claims Processing
  • Documentation skills
  • Excellent administrative abilities
  • Medicaid knowledge
  • Eligibility Determination
  • Data Entry Software

Certification

  • Diploma in Computer Science
  • Diploma in Medical Insurance and Office Administration from Ross Medical School Huntsville Al (2017-2018)

Timeline

Health Care & Insurance Operations Senior Market

NTT Data
08.2023 - Current

Managing Director operations

Rocket city Learning Center
01.2021 - Current

Medical Billing and Office Administration

Happi Urgent Care Huntsville AL
06.2018 - 10.2020

Department Manager

Walmart - Madison, AL
08.2015 - 01.2020

Bachelors in Commerce -

Osmania University
Haritha Bussu