Pavan Gola

Claim specialist

Role
Claims Specialist at Wellcove
Location
Delhi, IN
LinkedIn followers
500 followers

Experience

  1. Claims Specialist

    Wellcove

    Dec 2022 — Present · Noida, IN

    Working on US Healthcare on Claim Adjudication. • Worked on accident and wellness line of business claims. • Checking Eligibility of Member in insurance portal, Co-ordination of Benefit (COB), and we also check the necessary information such as providers, diagnosis codes, CPT codes, correct place of service etc. • Worked on Open PM, PEGA, CPS (claim processing system), Claim Central, UB04, CMS 1500, U200 and nonstandard Billing. • To prepare the reports of assign work, quality and production and share with team members in absence of team lead. • Knowledge and use of ICD-10, Revenue codes and CPT Coding. • Work on Escalation’s and Beelines and take immediate action within deadline.

Education

  • Delhi University

    Bachelor of Commerce - BCom

    2018 — 2019

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Pavan Gola — Claims Specialist at Wellcove in Delhi, IN | Unifers