Shweta Singh
Summary
Experienced clinical investigator with a proven track record in the hospital and healthcare industry. Detail-oriented team player known for strong organizational skills. Capable of managing multiple projects simultaneously with a high level of accuracy.
Overview
4
4
years of professional experience
Work History
Clinical Investigator
Optum UnitedHealth Group
05.2022 - 02.2024
- Experience in identifying & processing fraud, waste, and abuse between medical records and billing services for complex and high-value claims.
- Devised Up-coding, Unbundling, Duplication, and Misrepresentation of services and prevented the payment of potentially fraudulent and/or abusive claims saving upto $1000 each claim.
- Knowledge of CPT/diagnosis codes, and CMC guideline along with referring to clientspecific guidelines and member policies.
- Ability to accurately assign appropriate diagnostic and procedural codes.
- Knowledge of insurance guidelines, payer policies, and regulatory requirements.
- Analytical skills to identify coding errors or discrepancies leading to denials.
- Experience in reviewing denial reasons and determining appropriate actions for resolution.
- Effective communication skills to collaborate with healthcare providers and insurance companies.
- Attention to detail to ensure coding accuracy and compliance with coding guidelines .
- Ability to work efficiently under pressure and meet deadlines.
- Familiarity with denial management software or systems for tracking and resolving denials.
- Continuous learning and staying updated with changes in coding regulations and industry trends.
Physiotherapist Trainee
PSRI Hospital Delhi
10.2019 - 03.2020
- To provide physiotherapy and treatment for both outpatients and inpatients and also to be responsible for managing a clinical caseload, providing physiotherapy assessment and treatment to the highest standard.
Education
Bachelors of Physiotherapy -
Manav Rachna University
06.2019
12th -
Kalka Public School
06.2015
10th -
Amrita Public School
05.2013
Skills
- Professional mannerisms
- Time management
- Coding accuracy
- Code review
- CPT & HCPC Coding
- Analytical thinking
- Deadline management
- Medical record reviewing
- Software proficiency
- Team collaboration
- Adaptability and flexibility
- Attention to detail
- Continuous improvement
- Interpersonal skills
Accomplishments
- Received the Best Performer Award at OPTUM by effectively collaborating with the team.
Internship
PSRI Hospital, Delhi, Physiotherapist Trainee, 10/2019, 03/2020
Personal Information
- Title: Clinical Analyst
- Date of Birth: 08/06/1997
- Nationality: Indian
Projects
The effect of diaphragm breathing in anxiety performed on college students.
Hobbies
Cooking is like a therapy to me as I find peace when I cook for my family. And travelling is an escape from all the chaos, it helps me uplift my energy for the future tasks.
Timeline
Clinical Investigator
Optum UnitedHealth Group
05.2022 - 02.2024
Physiotherapist Trainee
PSRI Hospital Delhi
10.2019 - 03.2020
Bachelors of Physiotherapy -
Manav Rachna University
12th -
Kalka Public School
10th -
Amrita Public School
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