Kiruthika S

Results-driven Revenue Cycle Management (RCM) professional with 3.6+ years of end-to-end RCM experience spanning denial management, EOB review, payment posting, correspondence review, accounts receivable (AR), bad debt, and appeals processing. Consistently exceeds 100% daily productivity targets while maintaining 100% quality standards. Proven expertise in insurance eligibility verification, payer portal operations, and EPIC.

Strong analytical thinking, excellent written and verbal English communication skills, and ability to resolve complex claim issues independently. Comfortable working US shift timings and meeting stringent turnaround targets.

Senior Executive – AR / Senior Process Analyst - Omega Healthcare

(2024-07 - 2026-05)

• Managed end-to-end RCM functions including denial management, EOB review, payment posting, correspondence review, bad debt processing, and accounts receivable follow-up.
• Processed and resolved insurance claim denials by performing root-cause analysis and executing corrective actions to maximize revenue recovery.
• Conducted EOB (Explanation of Benefits) review to validate payments, identify underpayments or contractual adjustments, and post payments accurately.
• Handled correspondence review and bad debt workflows, escalating complex cases and ensuring timely resolution across multiple payers.
• Managed appeals process for denied and underpaid claims, preparing supporting documentation and submitting appeals within payer deadlines.
• Reviewed patient eligibility, insurance coverage, benefits, and authorizations using payer portals and EPIC to minimize claim rejections.
• Achieved 100%+ daily productivity targets consistently while maintaining 100% accuracy — demonstrating strong typing speed (30+ WPM) and attention to detail.
• Operated independently as Subject Matter Expert (SME), resolving complex claim scenarios and cross-functional escalations with little or no supervision from lead.
• Mentored and trained new team members on RCM workflows, payer guidelines, EOB review, and denial best practices, improving team-wide efficiency.
• Collaborated with key stakeholders and leadership to troubleshoot operational issues, streamline workflows, and reduce turnaround times across projects.
• Developed in-depth knowledge of business processes facilitated by RCM software products including EPIC and payer portal tools.

Senior Associate – KPO (RCM) - Atos Syntel

(2023-10 - 2024-06)

• Performed end-to-end denial management including review, root-cause analysis, corrective action, and timely claim resolution across multiple payers.
• Conducted eligibility verification by validating patient insurance coverage, benefits, and policy details through payer portals and direct payer calls.
• Posted payments and reviewed EOB documents to ensure accurate payment reconciliation and identification of discrepancies.
• Coordinated with internal teams to ensure accurate claim submission, minimize rejections, and maintain compliance with payer guidelines.
• Utilized EPIC and insurance portals to validate claim status, update records, and report claim outcomes efficiently.
• Maintained high accuracy and productivity metrics while adhering to compliance standards and daily operational targets.

Associate – AR - Guidehouse

(2022-10 - 2023-10)

• Performed insurance eligibility verification by validating patient coverage, benefits, and authorizations to reduce claim rejections.
• Handled denial management workflow by analyzing root causes of denials and implementing corrective actions for timely reimbursement.
• Reviewed correspondence and coordinated with insurance providers to ensure accurate claim processing and minimize reimbursement delays.
• Maintained compliance with healthcare regulations and payer-specific policies while ensuring data accuracy throughout the RCM process.
• Utilized MS Office, MS Excel, and claim management systems to track, update, and report claim statuses with high accuracy.
• Delivered strong performance metrics including claim resolution rate, quality accuracy, and turnaround time consistently.

MSc - Information Security & Cyber Forensics - University of Madras (2023 - Present)

BSc - Computer Science - Prof. Dhanapalan College of Arts and Science (2019 - 2022)