Summary
Overview
Work History
Education
Skills
Timeline
Generic

Nanda Chand

Sacramento,CA

Summary

Health insurance regulations, policies, procedures, Medicare, Medicaid, CCS, county programs, commercial insurance, and third-party payor requirements are handled here, including billing requirements for outpatient and inpatient hospitals and professional fee billings for commercial payers. Knowledge of University contract, agreements, Knowledge of ESRI software, computer systems, tools, and equipment for GIS mapping. Integrates GPS data into GIS databases and collects, records, and analyzes geographic information using the Global Positioning System (GPS). Receiving and formatting data, and/or transferring CAD files to GIS databases

Overview

20
20
years of professional experience

Work History

PATIENT BILLER III

UC Davis Medical Center
Sacramento, CA
06.2019 - Current
  • Reviewed Professional Billing Group billing, composed appeal letters for denials, invalid codes, and patient eligibility, and contacted payers via phone or email for commercial payers
  • Identify and correct potential problems including charges corrections, undistributed payments, and medical records coding corrections
  • Applied HIPAA privacy and security regulations while handling patient information
  • Updated demographic and insurance information as needed when patients' coverage changed.

DATA SUPPORT SPECIALIST

Hill Physicians
Sacramento, CA
03.2019 - 06.2019
  • The authorization data is exported from Epic and imported into Microsoft Excel, sorted, and filtered daily, and then forwarded to the analyst for analysis
  • To approve or deny hospital and professional authorization requests by CMS guidelines
  • Documentation from the EMR is used when writing referral letters to agencies and letters to patients.

PATIENT BILLER III

UC Davis Medical Center
Sacramento, CA
05.2005 - 07.2012
  • Comprehend payer regulations and reimbursement methodologies for commercial payers, including Medi-Cal, CCS, and Managed Care Plans for inpatient and outpatient hospitals
  • Review and resolve reimbursement issues relating to a non-processing, underpaid commercial payor
  • Reported payer issues (i.e., patient eligibility, invalid codes, underpayment of provider enrollment terms dates) to the appropriate parties to prevent rejections or denials in the future
  • Conducted analysis and identification of unpaid accounts by analyzing details, composing appeal letters, and using the phone and website to collect on accounts with strict time limits of over $1 million
  • Keeping current knowledge of competing and initial insurance regulations
  • Trained new hires in outpatient hospital follow-up

BILLER PATIENT II

UC Davis Medical Center
Sacramento, CA
09.2003 - 05.2005
  • A hospital's explanation of inpatient and outpatient benefits was analyzed by manually applying contractual reimbursement and transferring patient responsibility according to the hospital's contract and letter of agreement with commercial payors
  • Clerical duties include copies of medical records, sorting incoming mail, etc.

Education

B.A. - Geography (Geographic Information Systems and Analysis

California State University

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Los Rios Community College

H.S. Diploma - undefined

SSKMC High School

Skills

SOFTWARE SKILLSundefined

Timeline

PATIENT BILLER III

UC Davis Medical Center
06.2019 - Current

DATA SUPPORT SPECIALIST

Hill Physicians
03.2019 - 06.2019

PATIENT BILLER III

UC Davis Medical Center
05.2005 - 07.2012

BILLER PATIENT II

UC Davis Medical Center
09.2003 - 05.2005

B.A. - Geography (Geographic Information Systems and Analysis

California State University

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Los Rios Community College

H.S. Diploma - undefined

SSKMC High School

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Nanda Chand