Poonam Shukla
Fullerton,CA
Summary
Experienced medical office professional with expertise in correcting and resubmitting claims, preparing patient charts, and reviewing health records to identify accurate diagnosis codes for billing. Skilled in reviewing, analyzing, and managing medical record information to secure prior authorizations from insurance companies and ensure timely payment.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Stock Trader
Self-employeed
03.2018 - Current
- Increased overall portfolio returns by analyzing market trends and executing strategic trades.
Medical Claims Analyst
Vipul
03.2008 - 04.2010
- Increased patient satisfaction by efficiently processing insurance claims and addressing inquiries.
- Reduced claim denials by verifying patient eligibility and coverage details prior to submission.
- Enhanced data accuracy by meticulously updating patient records and insurance information in system.
- Provided exceptional customer service, assisting patients in understanding their insurance benefits and financial responsibilities.
- Verified patient insurance coverage and benefits for medical claims.
- Paid or denied medical claims based upon established claims processing criteria.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
Medical Claims Analyst
E-Meditek Solutions
07.2007 - 03.2008
- Enhanced claim processing efficiency by implementing automated workflows and streamlining procedures.
- Reduced fraudulent claims by conducting thorough investigations and collaborating with the fraud detection team.
- Improved customer satisfaction by resolving complex medical claims in a timely and professional manner.
- Ensured accurate payments by meticulously reviewing medical records, invoices, and supporting documentation.
- Managed high-volume caseloads for optimal productivity while maintaining strict attention to detail.
- Provided exceptional customer service, addressing inquiries regarding coverage, benefits, and claim statuses promptly and professionally.
- Assisted in the development of standardized processes for claim adjudication across multiple insurance products.
- Verified patient insurance coverage and benefits for medical claims.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Enhanced claim processing efficiency by implementing automated workflows and streamlining procedures
Medical Doctor(Homeopathy)
Self Practice
04.2004 - 04.2010
- Established strong relationships with patients and their families, fostering trust and commitment to the healthcare plan.
- Educated patients and families on benefits of healthy diet and adequate exercise.
Medical Doctor(Homeopathy)
Dr JPS Bakshi
02.2000 - 03.2004
- Improved patient outcomes by implementing evidence-based treatment plans and thorough followups.
- Educated patients and families on benefits of healthy diet and adequate exercise.
- Recorded patients' health histories and provided consultations weekly.
- Established strong relationships with patients and their families, fostering trust and commitment to the healthcare plan.
- Medical Content writer and set up an Alternate /Herbal Medicine store
Education
Pharmacy Technician
North Orange County of Continuing Education
04.2025
Medical Terminology
North Orange County of Continuing Education
12.2021
Human Relations For Health Care
Noth Orange College of Continuing Education
12.2021
Medical Insurance Coding
AAPC
11.2012
Bachelor of Science - Homeopathic Medicine
National Institute of Homeopathy
08.1999
Skills
- Paperwork Processing
- Documentation Skills
- Critical Thinking Abilities
- Fluent in English
- Patient History Understanding
- Strong Communication Skills
- Medical Transcription Abilities
- HIPAA Compliance Knowledge
- Multitasking Capabilities
- Diagnostic Coding Familiarity
- Anatomy and Physiology Understanding
- Computer Literacy Proficiency
- Medical Billing Familiarity
- Stock trades
- Market trends
- Financial statement analysis
Accomplishments
- Resolved product issue through consumer testing.
Certification
Post graduate diploma in Clinical research.
Certification in Multimedia
Languages
Hindi
Timeline
Stock Trader
Self-employeed
03.2018 - Current
Medical Claims Analyst
Vipul
03.2008 - 04.2010
Medical Claims Analyst
E-Meditek Solutions
07.2007 - 03.2008
Medical Doctor(Homeopathy)
Self Practice
04.2004 - 04.2010
Medical Doctor(Homeopathy)
Dr JPS Bakshi
02.2000 - 03.2004
Medical Terminology
North Orange County of Continuing Education
Human Relations For Health Care
Noth Orange College of Continuing Education
Medical Insurance Coding
AAPC
Bachelor of Science - Homeopathic Medicine
National Institute of Homeopathy
Pharmacy Technician
North Orange County of Continuing Education
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