Harshita Shukla

Detail-oriented Revenue Cycle Management professional with 4+ years of progressive experience in US healthcare billing, AR follow-up, denial management, and data-driven process improvement. Demonstrated ability to manage end-to-end RCM operations, lead team-level quality assurance as an Acting SME, and deliver measurable results on client KPIs including AR days, denial rates, and claim resolution. Strong command of EDI, Advanced Excel, Power BI, and SQL, with hands-on expertise across multiple healthcare BPO environments.

Committed to compliance, accuracy, and continuous process improvement.

Senior Analyst – Revenue Cycle Management at Finthrive (2025-07 – Present)

• Manage end-to-end AR follow-up and denial resolution for US healthcare payers, ensuring timely claim closure.
• Handle EDI rejections, correspondence review, and payer-specific escalations with a focus on first-pass resolution.
• Analyze AR aging data and denial trends using Advanced Excel and Power BI to drive corrective action.
• Coordinate with cross-functional teams to resolve bulk claim issues and reduce outstanding balances.
• Adhere to federal and state compliance standards; ensure accuracy of work through self-audit protocols.

Senior Analyst – RCM | Acting SME at CGM ARIA Health Services (2023-07 – 2025-07)

• Acted as SME for a team of 7 FTEs — overseeing daily productivity, maintaining team quality scores, and conducting floor-level coaching and feedback.
• Managed client escalations independently, ensuring SLA adherence and professional resolution within defined turnaround times.
• Maintained and reported client KPIs including AR days, denial rate, and collection rate; shared weekly performance dashboards with clients.
• Owned the team issue tracker — documenting recurring denial patterns, root causes, and resolutions to prevent recurrence.
• Successfully resolved 250+ claims denied for credentialing issues by coordinating with providers and payer credentialing teams, resulting in full reimbursement.
• Led denial management across multiple payers; handled authorization, eligibility, recoupment, and offset issues.
• Generated standard and nonstandard reports per quality and productivity metrics for relevant departments and medical centers.

Senior Analyst – Accounts Receivable at R Systems Internationals (2022-11 – 2023-07)

• Executed AR follow-up, EDI rejection resolution, and recoupment/offset issue handling for US payer accounts.
• Identified bulk denial trends through data review; collaborated with team leads to implement process corrections.
• Supported compliance reporting by ensuring accuracy of daily work output and escalating non-standard queries.
• Assisted in training junior team members on payer-specific workflows and denial resolution protocols.

Senior Analyst – AR & Denial Management at Optum Global Solutions (2022-07 – 2022-11)

• Handled denial management, claims follow-up, and eligibility verification for large US health plan accounts.
• Maintained AR aging reports and flagged high-risk accounts for priority resolution.
• Participated in process improvement discussions and assisted in documenting workflow updates.

Analyst – Accounts Receivable at Pacific BPO Pvt. Ltd. (2021-04 – 2022-07)

• Initiated career in US healthcare RCM; responsible for AR follow-up, claim submission, and initial denial handling.
• Learned payer-specific billing protocols and demonstrated rapid adaptability across multiple client accounts.
• Maintained accurate documentation of claim statuses and follow-up actions in practice management systems.

Bachelor of Arts – University of Lucknow (2018 – 2021)