Abhay Kumar

Medical Billing Specialist - Footprints Mental Health Counselling

(2026-02)

Manage end-to-end commercial RCM and billing workflows for the counseling group, ensuring accurate, compliant, and clean claim submissions for all mental health providers.
Oversee daily claim creation and submission processes, ensuring precise usage of behavioral health modifiers and specialized CPT codes (e.g., 90834, 90837, 90847) to boost first-pass acceptance rates.
Lead denial management and commercial billing resolution initiatives, systematically analyzing aged claims, resolving coordination of benefits (COB) issues, and filing strategic appeals to eliminate timely filing rejections.
Execute comprehensive commercial eligibility verification and detailed benefits breakdown (including deductibles, mental health co-pays, and co-insurance) to secure accurate patient data prior to clinical counseling encounters.

RCM Specialist (Billing, Eligibility & AR Follow-Up) - Rapid Care at Home

2 Years

Managed the complete end-to-end RCM cycle, seamlessly executing high-volume front-end billing operations, insurance eligibility checks, and back-end commercial AR follow-up.
Conducted aggressive AR follow-up on aged, unpaid, and short-paid behavioral health claims, effectively reducing outstanding Accounts Receivable days and accelerating provider cash flow.
Acted as the key liaison with US commercial insurance payers to audit, appeal, and successfully resolve unpaid, underpaid, or denied behavioral health claims, securing full revenue recovery.
Performed deep-dive Insurance Eligibility and Verification of Benefits (VOB) for diverse provider portfolios, with a heavy focus on managing prior authorizations for intensive mental health services.
Maintained meticulous documentation of commercial insurance responses, benefit caps, and pre-authorization requirements to streamline error-free billing workflows for clinicians.
Consistently exceeded established productivity and quality assurance billing metrics, contributing to a measurable reduction in outstanding AR aging buckets.

Payment Posting Associate - Coronis IT Systems Pvt Ltd

1.5 Years

Managed high-volume financial posting for US-based medical and behavioral practices, achieving 100% accuracy in balancing electronic and manual financial records.
Processed Commercial Insurance Payments (ERAs), Patient Payments (co-pays/deductibles), and Manual Checks (EOBs) efficiently while maintaining zero-variance reconciliations.
Analyzed Explanations of Benefits (EOB) and Electronic Remittance Advices (ERA) to rapidly identify behavioral health denials, underpayments, and recoupment trends for the billing and AR teams.
Reconciled daily deposits and managed complex financial actions including commercial contractual write-offs, payment adjustments, and secondary billing triggers.

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