Kalpesh Yadav

High-performing RCM Specialist with a BSc in Information Technology and 4+ years of experience optimizing the medical billing lifecycle. Expert in navigating high-complexity specialties including Anesthesia, Radiology, and Oral & Maxillofacial Surgery (OMS). Proven track record of leveraging technical SQL skills and root-cause analysis to resolve denials, reduce DSO, and bridge the gap between medical and dental billing systems.

Committed to applying software engineering principles—predictability, error reduction, and rigorous documentation—to maximize revenue recovery.

Senior Medical AR Executive at MEDUSIND (2024-10 – Present)

• Specialty Workflow Management: Lead AR follow-up for Radiology and Anesthesia, ensuring accurate application of modifiers (e.g., -26, -TC, -51, -52) and validation of anesthesia time-units to prevent revenue leakage.
• Denial Engineering: Analyze payer denial trends to develop systematic "correction scripts," reducing recurring rejections for medical necessity and timely filing by 20%.

Senior AR & OMS Specialist at BEANBITE DENTAL OFFICE SOLUTIONS (2023-06 – 2024-08)

• Medical-Dental: Specialized in Oral & Maxillofacial Surgery (OMS) billing.
• Revenue Bridge Management: Navigated the complex "Double Denial" workflow, coordinating between dental and medical carriers to ensure zero loss in surgical revenue.
• Process Standardization: Authored 10+ Standard Operating Procedures (SOPs) for eligibility and pre-authorization, reducing team onboarding time by 30%.
• Strategic Appeals: Achieved a high recovery rate on aged AR (90+ days) by drafting high-level clinical appeal letters for complex reconstructive and trauma cases.

Customer Relationship Manager at EMPIRE WEBTECH PVT LTD (2022-03 – 2023-05)

• Portfolio Optimization: Managed high-value client accounts, ensuring long-term retention through proactive milestone tracking and data-driven performance reviews.
• Feedback Loops: Acted as the "Voice of the Customer" to influence product roadmaps based on user-reported technical pain points.

BSc in Information Technology – Lok Jagruti University (2020 – 2025)

Higher Secondary Education in Commerce – A.I.M International School