Pavan Gola

Claims Specialist @Wellcove

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.

Delhi University

Bachelor of Commerce - BCom