Clinical Reviewer

Name: Nooliveti Teja Sree Noolivetitejasree1995@gmail.com

Mobile: +91- 81429 76262

Over 2 years of experience as a Clinical reviewer and To be associated with a professional organization to
accept challenges and aim towards the attainment of mutual and organization goals.

Over the next five years, aiming to contribute significantly to cutting-edge projects while expanding
leadership responsibilities in the Clinical Reviewer job.

PROFESSIONAL SUMMARY

 Worked as a lecturer at Penubala Institute of Medical Sciences. from Nov 2019 to Dec 2021.
 Working as an SME at Sagility India Private Limited from Jun 2022 to Present.

EDUCATION

 BSc-Nursing from Dr NTR University of Health Sciences. Andhra Pradesh.

Roles & Responsibilities:

 Reconciling on Invoice Billing for both Standard Billed and Self Billed.

 Have to Investigate Health insurance Claims and find out over and less payments.

 Processing Claims according to the process guidelines.

 workings as a clinical reviewer for (medical bills), so that client can claim their medical bills
accurately.

 I will check the quality of the billing. and ensuring all medical bills are billed as per state schedule.

 3. review the final medical record and approve for payment.

 4. validate the original and billed payments. and ensure there is no gap. 5. Relatedness and
Compensability validation.

 6. body parts validation as per bill.

 Have to meet monthly production and quality scores as per SLA.

 Maintaining reports like Audit inventory, batch reassign and ending inventory.

 Assigning the Complete & Reroutes work item to do Internal/Pre audit.

 Monitoring for all the internal audits regarding the process.

 Querying & applying the receipts through Customer Address, Customer No & Matching the Invoice
as per Check backup.
  Preparing process documents.

 Training for new joiners.

Achievements:

 Initiated Perfect Service document project (Process Improvement Idea) which saved $1073.00 and
Man-hours and thus was appreciated by clients.

 Received the Top Gun Award 4 times for being the outstanding performer of the month.

 Received Stardom Award for maintaining 100% quality.

 Received the Best Buddy Award 6 times for being the Best Mentor.

Skill Set
Accounting Packages: Tally ERP 9.0
Ex-Cell, word, windows and PPT.

Personal Information

Name : Teja Sree .N

Father’s Name : Thirupathaiah .N

Date of Birth : 03-10-1995

Marital Status : Single

Nationality : Indian

Present Address : # 1-985, Bandlavanka, Piler

Andhra Pradesh.

Declaration:

I hereby declare that all the information furnished above is true to the best of my knowledge.

Date: Signature
Place: Bangalore TejaSree N