Thirunavukkarasu
About Candidate
4+ year experience in US health care industry claim Adjudication process with HIPPA compliance and 5 years’ experience in manual testing in US healthcare Domain in Accenture company and EDI claim processing 837,834,835,277,999 files and EDIFICES. I will join immediately.
Location
Education
Computer Application
Computer science
Work & Experience
● Working as a Functional Tester For Insurance Project. ● Good and adequate Knowledge of EDI Transaction (834 Enrollment and 837 Claims). ● Played a major role in testing the Health Rules Application Scenarios and executed Validate the test case in ALM. ● Extensive experience in preparing Test Plans, writing Test Cases, execution, and Performed Smoke Testing. ● Involved in various HIPPA testing and Validation for EDI transaction using 834,835,837,277,999. ● Involved in Defect and SF ticket validation.
● Performing audit of randomly selected claims to ensure quality processing. ● In-depth knowledge of medical terminology in relation to diagnosis and procedures. ● Decision-making, effective communication, analytical and research-oriented tasks. ● Ability to process claims for surgery, radiology, lab, and medicine for professional and facility claim forms. ● To Maintain the Inventory report.
● This position is responsible for processing medical claims for the individuals and assuring proper payment in keeping the insurance benefit plan. ● Following healthcare adjudication policies and procedures to make sure do not disclosure patient’s health information to others. ● Daily doing production from the online inventory management report. ● Handling and releasing the new joiner’s production report. ● Applying correct provider discount, deductible, co-payment, coinsurance, health insurance payments