Mahesha B
Seasoned Leadership Professional with 10+ Years of Expertise in Healthcare Operations, Team Supervision, and Process Automation Across Specialty Practices
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About
Results-driven AR Calling Revenue Cycle Management (RCM) Leader with 10+ years of specialized experience in healthcare operations, team supervision, and process automation across specialty practices. Proven success in AR Calling end-to-end RCM operations, including AR follow-up, denial management, and claims resolution, ensuring 100% compliance and zero client escalations. Recognized for leading award-winning teams, implementing automation to enhance performance metrics, and aligning operational processes with Cardinal Health's specialty expansion goals.
Expertise in NextGen EHR, multi-portal management (Urochart, Instamed, Phreesia, Luma), and data analytics using Advanced Excel and KPI reporting tools. Strong communicator and mentor, fostering collaboration across payers, providers, and cross-functional teams to ensure high-quality service delivery. Dedicated to continuous improvement, driving revenue cycle efficiency and process excellence within complex healthcare environments.
Experience
LEAD -AI Solution Analyst Architect - Waterlabs AI Technologies Pvt Ltd
(2025-12)
- Lead AI-driven solution design and architecture for healthcare Revenue Cycle Management (RCM) workflows, aligning AI capabilities with operational goals
- Architect end-to-end AI automation frameworks for claims processing, denial management, and AR follow-up, leveraging machine learning and NLP models
- Collaborate with cross-functional teams including engineering, product, and client stakeholders to translate RCM domain expertise into scalable AI solutions
- Drive continuous performance analysis using advanced data analytics and KPI dashboards to monitor AI solution impact on revenue cycle metrics
- Patient Estimation Automation implemented for an external client, streamlining pre-service financial workflows
- Face Sheet PDF Movement Automation deployed for an external client, eliminating manual document handling
- Prior Authorization Process Automation executed for selected payers, reducing turnaround time and manual effort
- Authorization Follow-Up Process Automation implemented for selected payers, improving follow-through rates
- Medicare COB Denials Process Automation developed, accelerating resolution of coordination of benefits denial claims
- Bulk No-Response Claim Upload and Action Process Automation in PM System, enabling high-volume claim management efficiently
AR Calling Senior Team Leader - Omega Healthcare Management Services Pvt. Ltd.
(2017-04 - 2025-08)
- Direct RCM operations for Urology specialty practices under Cardinal Health's network, managing claims lifecycle, AR follow-up, denials, and payment posting
- Maintain 100% compliance and zero client escalations for over eight years through strict adherence to operational standards and payer guidelines
- Spearheaded service expansion for Prostatic Artery Embolization (PAE), coordinating directly with clients and payers to define custom operational workflows
- Initiated AR automation for high-touch claim categories, optimizing manpower utilization and improving turnaround time (TAT)
- Enhanced NextGen EHR utilization by developing advanced report extraction models and partial file maintenance templates supporting decision-making
- Led a multi-provider team within Cardinal Health's Urology network, standardizing processes that align with enterprise-wide quality benchmarks
- Basic Medical Coding (ICD-10, CPT, HCPCS)
- Awarded 'Best Team Leader' (Three Times) for operational excellence and leadership
- Awarded 'Best Team' (Twice) for operational excellence and leadership
Senior AR Analyst - SysInformation Healthcare India Pvt. Ltd. (Dominion Process – Monmouth Medical Imaging)
(2015-02 - 2017-04)
- Managed accounts receivable and denial resolution for radiology clients, ensuring accuracy and compliance in claims submission
- Liaised with healthcare providers and payers to resolve complex claim discrepancies, improving cash flow and reducing claim rejections
- Monitored aging reports, optimized follow-up strategies, and contributed to achieving consistent collection targets
Process Developer – Mortgage Verification Division - ThoughtFocus Technologies Pvt. Ltd.
- Developed and optimized mortgage verification processes leveraging IVR systems for U.S.-based lenders
- Retrieved, validated, and documented detailed loan information (balances, due dates, escrow details)
- Enhanced data accuracy and workflow consistency, skills later applied to financial accuracy in healthcare operations
Education
Bachelor of Commerce - B.Com - National Virtual University for Peace and Education
