Gopi Nath

Detail-oriented RCM professional with 3+ years of hands-on experience in Prior Authorization, Accounts Receivable, Denial Management, and Quality Auditing within Oncology and Chemotherapy specialties. Proven track record of improving claim accuracy, accelerating reimbursements, and ensuring compliance across major payer systems. Adept at working within pilot processes and driving measurable operational improvements.

Quality Auditor — Approved ATA Auditor (Onshore) - Access Healthcare Private Limited - Florida Cancer Specialists

(2025-07)

• Conducted internal and external quality audits for chemotherapy prior authorization cases, ensuring full ATA compliance and documentation accuracy.
• Identified recurring error trends and partnered with operations teams to implement targeted corrective measures.
• Actively contributed to pilot process enhancements, reducing rework rates and improving first-pass accuracy.

Executive – AR & Prior Authorization - Omega Healthcare Private Limited - Oncology Institute of Hope and Innovation

(2024-06 - 2025-06)

• Managed end-to-end accounts receivable and prior authorization activities for oncology and hematology services.
• Performed thorough insurance verification, initiated timely follow-ups, and resolved denial cases within established SLAs.
• Operated within a pilot process environment, contributing to workflow optimization and cross-functional collaboration.

Prior Authorization Agent - RND Softech Private Limited - Rotech Healthcare

(2023-02 - 2024-05)

• Handled insurance verification and prior authorization requests for Durable Medical Equipment (DME) and related medical supplies.
• Ensured timely approvals and maintained accurate documentation across multiple payer portals.
• Developed strong foundational knowledge in DME-specific coding, payer requirements, and HIPAA compliance.

B.Sc - Visual Communication - San International College of Arts & Science (2019 - 2022)