Overview
Work History
Education
Skills
Languages
Timeline
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Meghan Alagoni

Perth,WA

Overview

6
6
years of professional experience

Work History

Senior Quality Analyst

Reventics Private Limited
Hyderabad, Telangana
07.2022 - 02.2024
  • Led scheduled client calls, and prepared comprehensive process documentation. Worked as a Quality Lead for two teams.
  • Conduct 100% audits on high-risk accounts, and random audits on regular accounts.
  • Identify root causes for denials, billing errors, and AR follow-up deficiencies.
  • Provide feedback and training support to team leads and AR agents.
  • Collaborate with Ops, Training, and Compliance teams for process enhancement.
  • Implemented a new QA scorecard format, reducing audit cycle time by 15%.
  • Maintain SLA metrics: >98% accuracy,
  • Created detailed RCA reports and suggested corrective actions.
  • Conducted monthly performance knowledge tests (PKT) and shared results with operations to drive improvements.
  • Led quality calibration sessions with clients and internal teams.
  • Prepared and maintained daily audit reports, providing detailed insights to operations, along with weekly quality dashboards and variance reports.
  • Developed general notes and appeal formats to increase appeal success rates.
  • Played a key role in transitioning the new client process with 100% accuracy.

Team Coach

Newport Med Solutions
Hyderabad, Telangana
06.2019 - 07.2022
  • Leading a team of 12 AR associates handling multi-specialty U.S. healthcare clients.
  • Conduct daily huddles, performance reviews, and training sessions.
  • Monitor individual productivity, quality scores, and TAT adherence.
  • Prepare and present weekly AR dashboards and aging summaries to operations leads.
  • Initiated a denial trend tracker, improving the resolution rate by 18% in 6 months.
  • Collaborate with QA, billing, and coding teams to streamline the claim lifecycle.
  • Managed high-volume workers' compensation claims for multiple U.S. states, ensuring accuracy and compliance.
  • Conducted initial claim reviews, obtained employer reports, and coordinated with adjusters.
  • Verified patient eligibility, provider information, and medical records to process claims.
  • Handled provider and payer communications, including appeals and resubmissions.
  • Reduced claim backlog by 28% by streamlining documentation and follow-up cycles.
  • Trained three new hires on workers' compensation workflows and system usage.

Senior Associate

Advantum Health
Hyderabad, Telangana
10.2018 - 06.2019
  • Acted as a Subject Matter Expert (SME) and supported new hire onboarding.
  • Managed complex denials (CO-197, CO-18, CO-170, CO-45, CO-97, CO-29, etc.). For high-value claims.
  • Coordinating with coding and billing teams to correct claim data.
  • Worked on the follow-up of workers’ compensation claims, processed the first report of injury (FROI), documentation, and incident intake in workers’ comp systems.
  • Resolved denials (compensability issues, late reporting, provider mismatch), and submitted appeals.
  • Utilized EMR/EHR systems to match claims with supporting medical documentation.
  • Maintained over 98% accuracy in claim adjudication across audit cycles.
  • Conducting weekly AR aging reviews, and submitting appeals to payers.
  • Handle outbound and inbound calls to US-based patients regarding billing inquiries, statement clarifications, and outstanding balances.
  • Explain the Explanation of Benefits (EOBs), co-pays, deductibles, and balances clearly to patients.
  • Set up payment plans and process payments using secure systems.
  • Log call details and update patient records in the billing software.
  • Consistently achieving monthly targets (Productivity > 50 claims/day, Quality > 98%).

Associate

Medico
Hyderabad, Telangana
11.2017 - 10.2018
  • Performed insurance follow-up, and worked on unpaid and underpaid claims via phone and web portals (Availity, Navinet, Trizetto).
  • Specialized in working with commercial insurance, Medicare claims (Medicare, Medicaid, BCBS, Aetna, etc.). Along with workers' compensation claims.
  • Worked on the follow-up of workers' compensation claims with third-party administrators (TPAs).
  • Collaborated with provider networks to ensure timely submission and corrections.
  • Specialized in DME and physician billing accounts.
  • Resolved claim denials and rejections by identifying root causes.
  • Maintained thorough documentation in billing software and client systems.
  • Handled end-to-end Accounts Receivable for U.S. healthcare clients.
  • Achieved a 95% claim resolution rate within the turnaround time (TAT).

Education

Bachelor of Science - Computer Science

Megha Institute of Technology
Hyderabad
06-2017

Skills

  • Expertise in claims handling
  • Motor claims, property, and worker's compensation claims management
  • Strong customer service and client relationship management
  • Excellent organizational skills and task prioritization
  • CPT, ICD-10, and modifiers
  • Familiar with HIPAA compliance
  • MS Excel and Google Sheets
  • Voice process and communication skills
  • Knowledge of clearinghouses and payer portals
  • QA auditing (AR and denial management)
  • Root cause analysis (RCA)
  • Process documentation and SOP development
  • Error pattern identification and reporting
  • Performance calibration and feedback
  • Tools: Excel (Pivot, VLOOKUP), PowerPoint
  • Platforms: Epic, AMD, All Scripts, Infinity
  • Clearinghouse tools: Availity, Navinet

Languages

English
Professional
Telugu
Professional
Hindi
Professional

Timeline

Senior Quality Analyst

Reventics Private Limited
07.2022 - 02.2024

Team Coach

Newport Med Solutions
06.2019 - 07.2022

Senior Associate

Advantum Health
10.2018 - 06.2019

Associate

Medico
11.2017 - 10.2018

Bachelor of Science - Computer Science

Megha Institute of Technology

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Meghan Alagoni