Pushpa Sheebah Johnpaul
Summary
Driven Provider Enrollment Specialist with exemplary critical thinking and decision making talents and client relationships through expert data entry proficiency and effective communication. Specialized in Medicare and Medicaid, delivering process improvements and stringent deadline management, significantly boosting efficiency and compliance. An enthusiastic professional with more than 5 years' coordinating credentialing data for health practitioners. Ready to apply talent in financial eligibility processes with a new organization.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Provider Enrollment Specialist
NTT Data
04.2023 - Current
- Performed database maintenance for new and existing medical provider records, reporting and extracting data for various reports and analyses, initiating database improvement.
- Entered credentialing data into the provider data management system and maintained 99% data accuracy.
- Successfully built and maintained strong client relationships, managed accounts, and achieved client satisfaction.
- Contacted insurance carriers to obtain information regarding denials.
- Prepared and processed provider enrollments with Medicare and Medicaid in multiple states.
- Reviewed statistic enrollment data and prepared reports.
- Updated, entered, and reviewed customer data.
Senior Process Associate
Accenture
11.2014 - 07.2016
- Processing the medical claims correspond with insurance agents and beneficiaries followed to pay.
- Met month-end reporting objectives and deadlines.
- Investigated issues surrounding claims, payments, credentialing/recredentialing and pricing.
- Performed quality assurance checks on transactions and account actions to assess compliance with state and federal regulations.
- Identified modifications to processes and procedures that would promote better efficiency.
- Leveraged accounting software to perform data entry and prepare reports and statements while minimizing errors.
- Collaborated with team to define business requirements for organizational processes, achieve productivity standards, and adhere to accuracy standards.
- Identified and resolved process issues to drive optimal workflow and business growth.
Transaction Processor
Source HOV
11.2010 - 09.2013
- Reconciled documentation of file to provide accurate transfer of funds.
- Collaborate with customers at all levels of the organization to define objectives.
- Settled funds and verified accuracy in internal accounting system.
- Ensures that work is completed according to service level agreements.
- Performed quality assurance checks and reported issues to management to improve performance.
- Processed entries to make adjustments and post to client accounts.
- processing the first and third party injury coverages in an automobile accident.
- Completes department reports and logs as assigned.
Education
Bachelor of Engineering - Electronics And Communications Engineering
Anna University
05.2009
Skills
- Effective written and verbal communication
- Knowledgeable in healthcare
- Benefits Administration
- Workflow Optimization
- Data entry proficiency
- Financial eligibility processes
- Credentialing data coordination
- Medicare and Medicaid knowledge
- Deadline Management
- Client Relationship Building
- Knowledgeable in MS-office
Certification
Google Certified Data Analyst.
Timeline
Provider Enrollment Specialist
NTT Data
04.2023 - Current
Senior Process Associate
Accenture
11.2014 - 07.2016
Transaction Processor
Source HOV
11.2010 - 09.2013
Bachelor of Engineering - Electronics And Communications Engineering
Anna University
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