Manoj Venkateshbabu

Manoj Venkateshbabu

Quality Analyst |Pre-Auth verification| US Operation| Engineer |US healthcare |Professional Dancer

Chennai, Tamil Nadu, India
500 followers 491 connections

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Indian School of Management and Technical Studies (ISMTS)

About

A highly competent and result oriented Quality Analyst with a demonstrated history of working in the US hospital & health care industry offering over 7+ years of experience. Highly accurate and efficient with strong Training, Learning & Development, time management skills and reliable, hardworking nature with Excellent reputation for resolving problems and improving customer satisfaction. Dedicated to maintaining strict client confidentiality and ensure that office practices follow HIPAA regulations. Skilled in Prevention, Flexible Schedule, MS-excel and Adobe Photoshop. Strong operations professional with a Bachelor of Engineering - BE focused in CSE from ISMTS

Activity

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Experience

  • AGS Health

    AGS Health

    3 years 8 months

    • AGS Health Graphic

      Quality Analyst

      AGS Health

      - Present 1 year 9 months

      Chennai, Tamil Nadu, India

      Auditing the daily accounts completed by the operations team of 210 users. Generating production/quality reports on weekly basis and conducting review meeting based on the report. Analyzing the trend errors by keep tracking the quality reports. Conducting feedback meeting every for the associates and conducting low quality feedback weekly twice and giving feedback to improve the quality in the production.

    • AGS Health Graphic

      Senior Process Associate

      AGS Health

      - 1 year 9 months

      Chennai, Tamil Nadu, India

      Responsible for raising prior authorization requests and added clinical reports for Utilization Management Review and Assisting the team with 20+ associates and giving training to freshers to handle the EPIC software.
      Handled provider and customer calls, faxes, e-reviews for initiating Prior approval requests for one of the America's largest health insurance company
      Prioritized incoming authorization requests according to urgency
      Checked member's eligibility, benefits, coverage…

      Responsible for raising prior authorization requests and added clinical reports for Utilization Management Review and Assisting the team with 20+ associates and giving training to freshers to handle the EPIC software.
      Handled provider and customer calls, faxes, e-reviews for initiating Prior approval requests for one of the America's largest health insurance company
      Prioritized incoming authorization requests according to urgency
      Checked member's eligibility, benefits, coverage, dates of service
      Protect the confidentiality of patient's health information from other members and personnel in compliance with HIPAA.
      Check CPT codes to see if they require authorization for providers and fax results of inquiry to provider.
      Referred federal, BOR member requests to concerned departments
      Contacted the providers for additional or missing information for processing prior approval requests
      Analyzed data in response to requests for intelligence, research, documents, and other related requirements from Intelligence and Research analysts
      Submitted ideas on applying artificial intelligence in existing process which helped in cost cutting
      3 Provided process training to new members In the team and offered guidance whenever required

    • AGS Health Graphic

      Process Associate

      AGS Health

      - 1 year 3 months

      Chennai, Tamil Nadu, India

  • Sutherland

    Sutherland

    4 years 7 months

    • Sutherland Graphic

      Associate

      Sutherland

      - 1 year 6 months

      Chennai, Tamil Nadu, India

    • Sutherland Graphic

      Junior Associate

      Sutherland

      - 3 years 1 month

      Chennai, Tamil Nadu, India

Education

  • Indian School of Management and Technical Studies (ISMTS)

    Bachelor of Engineering - BE Computer Science

    -

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