Hariharan
Senior Quality Analyst - Healthcare Insurance Verification
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Hariharan R. is a seasoned Quality Analyst in the healthcare insurance sector, boasting over six years of specialized experience in Insurance Eligibility Verification, Verification of Benefits (VOB), and Prior Authorization. He has demonstrated proficiency with payer portals such as Availity, NaviNet, and Cigna, as well as EHR systems like Epic and Athena. Throughout his career, Hariharan has consistently maintained accuracy rates exceeding 95%, even when managing high-volume queues. At Vee Health Technology, he conducted quality audits on over 150 monthly cases, achieving 98%+ accuracy while reducing turnaround times by 30% through automation. He also played a crucial role at Business Integrity Services, conducting over 200 monthly audits and reducing audit exceptions by 35% with effective CAPA protocols. His expertise includes maintaining HIPAA compliance and collaborating with multiple departments to streamline operations. Hariharan holds a Bachelor of Software Applications, further enriching his technical proficiency in industry-specific systems.
Experience
Quality Analyst – Medical Billing
Vee Health Technology · 2026 — 2026Performed quality audits on over 150 monthly cases related to Eligibility Verification and Prior Authorization with an emphasis on accuracy. Verified patient insurance eligibility and benefits through payer portals (Availity, NaviNet, UHC, Aetna, Cigna) while ensuring compliance. Confirmed coverage specifics, including deductible and copayment details. Enhanced turnaround time by implementing automated tracking systems. Conducted Root Cause Analysis and took steps to reduce recurring errors while maintaining HIPAA compliance.Quality Analyst
Business Integrity Services Pvt. Ltd. · 2024 — 2025Executed quality audits on more than 200 monthly cases across various payers including Medicare and Medicaid, ensuring high accuracy in verification. Verified insurance details comprehensively, identifying documentation issues and providing actionable feedback. Worked collaboratively with provider and billing teams to expedite processing. Implemented CAPA protocols to minimize audit exceptions while consistently adhering to HIPAA standards.Senior Client Partner – Insurance Verification & Authorization
Access Healthcare Private Ltd. · 2023 — 2024Oversaw insurance verification and prior authorization processes for commercial and government payers. Verified patient eligibility, benefits, and authorization requirements while reviewing clinical documentation. Coordinated with various stakeholders, including insurance companies and providers, to secure timely approvals and followed up on authorizations to avoid delays in patient care.Senior Team Member – Eligibility Verification & Prior Authorization
First Focus BPO · 2019 — 2022Executed insurance eligibility verification and processed prior authorization requests for medical services. Coordinated with stakeholders to secure timely authorization while managing communication through inbound and outbound calls. Provided mentorship to junior associates, ensuring adherence to HIPAA compliance and SLA targets.
Skills & Expertise
Education
- Bachelor of Software Applications (BSA)Thiruthangal Nadar College · 2016 — 2019
- Higher Secondary Certificate (HSC)K C Sankaralinga Nadar Hr. Sec School · 2014 — 2016
- Secondary School Leaving Certificate (SSLC)K C Sankaralinga Nadar Hr. Sec School · — — 2014
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