Vishal Tosh
Reimbursement Analyst Ii -contract Compliance at Sutter Shared Services
Based in Elk Grove, United States
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Seniority
Staff
Department
Healthcare & Human Services
Location
Elk Grove
Industry
Hospitals and Health Care
Company size
442
Contact information
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v•••••••@sutterphysicianservices.com
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Background
About Vishal Tosh
Reimbursement Analyst II -Contract Compliance -CBO- Sutter Shared ServicesJob SummaryEpic Resolute Billing and IDX ExperienceMedicare,Medi-Cal,and Private insurance billing Reveune Cycle applications and Professional billingKnowledge & experience of creating healthcare fee schedules for insurance companies like Aetna, Cigna,United Healthcare,Blue Cross and Blue Shield using CMS guidelines and contract language.Interpreting and analyzing third-party reimbursements and denials NHXS -Business Intelligence tools and Denial Mgmt softwareExperience in Healthcare Professional Bill and Accounts Receivable Process Improvement -Utilize technology and lean methodologies to reduce waste,improve workflows and achieve effective outcomesAnalyse overpayments and process refund process according to contract language and CMS guidelinesAnalyse & Price Anesthesia, Ambulatory Surgery and Professional Claims for Underpayments
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