Ramesh Shivaji Gayagav

Performed quality assurance (QA) on Electronic Health Record (EHR) data for US healthcare providers, ensuring accuracy, completeness, and HIPAA compliance. Handled protected health information (PHI) securely in line with HIPAA regulations and US healthcare data privacy standards. Identified and corrected errors in clinical and administrative data to maintain high data quality standards. Prepared and maintained MIS reports to track quality metrics and support operational decisions.

Adjudicated US medical insurance claims by applying payer rules and policy guidelines to determine correct outcomes. Handled sensitive patient and claims data with HIPAA and US healthcare privacy compliance. Reviewed claims data for accuracy and consistency to ensure compliant and correct adjudication decisions. Processed high volumes of claims with precision using rule-based decision-making and judgment.

Provided customer support for telecom customers by resolving queries efficiently and professionally. Strengthened communication, problem-solving, and process-adherence skills in a fast-paced BPO environment.