Yash Khemani

Reviewed denied claims and supporting documentation daily to determine root cause, validity, and appropriate next-action steps, ensuring accuracy and completeness before case resolution. Investigated and resolved denial and billing discrepancy cases for major U.S. payers including BCBS, Aetna, and Priority Health, coordinating with internal teams to finalize outcomes. Handled 40-50 case-related inbound/outbound calls daily with 95% accuracy while maintaining quality and compliance standards in a high-volume, production-driven environment. Documented all case correspondence, findings, and outcomes accurately in Epic Hyperspace, maintaining confidential records and supporting audit-readiness. Followed payer-specific policies, procedures, and compliance/code-of-conduct standards on every case, ensuring accuracy and consistency across all determinations. Independently prioritized and managed multiple high-volume case assignments in a fast-paced environment. consistently meeting productivity and quality metrics. Maintained strict adherence to assigned schedules and performance metrics across a 24/7 rotating-shift structure, supporting reliable, round-the-clock case coverage. Collaborated with cross-functional teams to escalate and resolve complex denial and billing issues, improving overall resolution outcomes. Applied strong data entry accuracy and Microsoft Office skills (Outlook, Excel, Word) daily for case documentation, correspondence, and reporting. Adapted quickly to evolving processes, payer requirements, and account transitions, supporting smooth workflow changes.

Designed and built websites and web applications for small U.S.-based businesses, managing client requirements end-to-end from planning through deployment. Communicated directly with clients to gather requirements, provide updates, and ensure final deliverables matched business needs and branding.