Jayesh Shanbhag

Client Success professional with over 10 years of experience in Revenue Cycle Management (RCM), Client Coordination, and Accounts Receivable. Proven track record in managing client relationships, resolving operational issues, and driving process improvements. Adept at cross-functional collaboration, data analysis, and strategic communication to ensure client satisfaction and timely collections.

Assistant Manager – Client Success - Bizmatics India Pvt Ltd

(2025-09)

• Conduct mid-month forecast for client collections.
• Schedule and lead weekly client meetings on billing, posting, and AR.
• Prepare and share meeting agendas and MOMs.
• Coordinate with clients and internal teams to resolve billing posting and AR issues.
• Present monthly dashboards on billing, posting, and pending AR.
• Generate and follow up on monthly invoices as per contract terms.
• Facilitate monthly account review calls and internal operational meetings.
• Creating and sending month end reports to practice which includes (Total charges, collections and pending AR insurance v/s Patient)
• Hands on experience on software like Centricity, Eclinical works, Nextgen, Allsripts, Greenway intergy, Unlimited Systems, Tebra, Cirro, ModMed.
• Working with credentialing team for updates regarding network participation status for the providers.
• Enrolling providers for EFT/ERA where ever possible
• Working with operations team to check for any new trend in denials and providing an update to practice about the same.
• Providing upfront new changes been done by CMS in their policy.
• Updating practice regarding any changes in Fee schedule or billing guidelines related any CPT/HCPCS codes.
• Providing insurance specific guidelines to practice whenever requested or required for practice.
• Providing guidance to practice with regards to patients collections process, pre eligibility and authorization process which will help the practice to generate more revenue.
• Providing upfront information to providers regarding any patients claims that has been denied due bad eligibility to avoid any bad debt collection.
• Provide upfront reports to practice related to pre collections, bad debts which will help the practice to make more efficient front end process patient collection.

Process Lead – Oncology Account - Health Cell Services Pvt Ltd

(2016-08 - 2025-07)

• Managed oncology client accounts, ensuring accuracy in billing, AR follow‑up, and revenue cycle processes.
• Led monthly client review calls and provided detailed performance analysis and AR dashboards.
• Assigned tasks, tracked team productivity, and monitored performance metrics for billing and AR staff.
• Consolidated and validated daily/monthly billing, payment posting, and reconciliation reports.
• Resolved front-office issues related to billing, payment posting, denials, and AR workflows.
• Facilitated EFT/ERA enrollment to streamline reimbursement and reduce payment delays.
• Identified denial trends, conducted root-cause analysis, and communicated corrective actions to practices.
• Provided timely updates on CMS policy changes, payer reimbursement rules, and fee schedule adjustments.
• Ensured accurate use of CPT/HCPCS codes and maintained compliance with insurance-specific billing guidelines.
• Guided practices on patient collections, pre-eligibility verification, and authorization processes to improve revenue capture.
• Alerted providers about eligibility‑related denials to prevent bad-debt risks for ongoing treatment cases.
• Delivered reports on pre‑collections and bad debts to support front‑end process improvements.
• Conducted daily team meetings to resolve operational challenges across billing, posting, denials, and AR.
• Coordinated with pharmaceutical companies for drug reimbursement, rebates, and financial optimization.
• Managed patient enrollment and claim submission for Financial Assistance Programs (FAP).
• Delivered quarterly reports and presentations on denial trends, including increase/decrease analysis.
• Provided quarterly Oncology vs. Hematology patient volume insights.
• Created reports on top revenue‑generating drugs and top ICD codes for Oncology and Hematology.
• Provided proactive alerts on reimbursement reductions for high‑utilization drugs and recommended alternatives.
• Scheduled and reviewed monthly underpayment reports for drug codes and related administration codes.
• Prepared and presented quarterly credit balance reports for insurance and patient accounts.

Accounts Manager – Revenue Cycle - eClinicalWorks

(2016-02 - 2016-07)

• Conducted weekly client calls and internal billing/posting/AR meetings.
• Presented monthly AR reports to clients.

Accounts Receivable Executive - Health Prime Services India Ltd

(2013-12 - 2016-01)

• Followed up with insurance companies for claim resolution.
• Handled account-level appeals and denial management.
• Participated in weekly quality meetings and cleared denial inventory.

HSC