Shorya Rastogi

Spearheaded insurance claims processing ensuring accuracy and timely billing resulting in optimized revenue flow. Collaborated with insurance representatives to resolve claims processing discrepancies, maximizing claim payments. Contributed to process improvements by updating SOPs and mentoring junior team members. Independently managed Air and Ground Ambulatory processes, ensuring client satisfaction and retention. Conducted root cause analysis, reducing denied claims by 20–25%. Utilized SQL for data analysis, leading to a 90–95% reduction in duplicate claims. Developed dynamic dashboards in Excel and visualizations in Tableau for data-driven decision-making.

Researched and resolved claims discrepancies, ensuring accurate billing and prompt claim processing. Maintained daily reports in MS-Excel and communicated with insurance companies for payment verification.

Review, for correctness, claims made by the hospital's backend system and settle them. Make systematic checks to ensure prompt claim processing and effective billing. Optimized data retrieval processes and created interactive dashboards, reports, and visualizations using MS-Excel as per client requirements. Analyzed data, identified trends, and proposed solutions that resulted in a 20-25% reduction in denials. Conducted thorough analysis of insurance claims data using SQL, resulting in a 90-95% reduction in duplicate claims. Created interactive dashboards, reports, and visualizations using Power BI to effectively communicate findings and support data-driven decision-making.

Examine claims for accurate invoicing to reduce mistakes. Make follow-up calls and verify insurance payments. Conduct methodical examinations to ensure prompt claims processing and effective billing. Work together with insurance companies to address claim denials and partially or not paid claims. Acting as an AR Caller to maximiser income, I used applied data analysis to track and follow up on unpaid claims within the parameters of the regular revenue cycle.