Director RCM Operations - IKS Solutions
(2024-08 - 2025-06)
- Develop and implement comprehensive strategies to optimize revenue collection and reduce revenue leakage
- Set financial goals and benchmarks for the RCM team and ensure alignment with the overall financial objectives of the organization
- Analyze market trends, payer policies, and regulatory changes to adapt revenue strategies accordingly
- Evaluate and streamline RCM workflows to enhance efficiency and accuracy in billing, coding, and collections
- Implement and leverage advanced RCM technologies, including automation tools, analytics platforms, and electronic health records (EHR) systems
- Identify and disseminate best practices for revenue cycle processes across the organization
- Lead and mentor the RCM team, including managers, billing specialists, coders, and other staff members
- Provide ongoing training and professional development opportunities to enhance the skills and knowledge of the RCM team
- Monitor team performance, conduct regular reviews, and implement corrective actions to achieve optimal outcomes
- Conduct detailed financial analysis to identify trends, variances, and areas for improvement in revenue collection
- Generate and present regular reports on revenue performance, key performance indicators (KPIs), and financial metrics to senior management
- Monitor and manage costs associated with the revenue cycle to ensure cost-effectiveness and profitability
- Foster a culture of continuous improvement within the RCM team by encouraging innovation and the adoption of new technologies
- Benchmark organizational performance against industry standards and implement improvements to achieve best-in-class status
- Collaborate with clinical and operational leaders to align revenue cycle processes with overall organizational goals
Manager Operations - GeBBS Healthcare Solutions Pvt Ltd
(2022-08 - 2024-08)
- People Management (Head Count Management, Attendance, Attrition, Prohance-Workforce Analytics and Productivity Measurement, New Agent Request, EOQ-Fix % of extra users, Late Coming Tracker)
- Employee Management (Employee Welfare Fund, Skip Level Meeting, Performance Improvement Plan)
- Process Improvement / Management (Correct AR Action, Effectiveness Matrices)
- Operations Management (Daily Production Tracker, TL Playbook, Seat Management, MBR, VOIP usage report, AR Quality Report, AR Productivity Report, Attrition Dashboard, Daily Head Count Report)
- Client Management (Client Call Management, Monthly Business Review Deck, Client Login ID Reconciliation, Client Complaint Tracker, Client Downtime Tracker)
- Part of an automation and innovation team that involves the use of technology and systems to perform tasks with minimal human intervention
- Deployed multiple BOTs including web extraction BOT, and RPA, which help to obtain eligibility from web portals and fetch the ERAs from clearing house and extract the fax
- Conducting monthly one on one and appraisal for DR's
- Prepare monthly, quarterly forecast reports
- Ensure all team members follow the accounting principles
- Excellent analytical skills along with the ability to create and present detailed reports
- Team management and negotiation skills Problem-solving attitude
- Managing an operation team of 253 FTE's, which includes 2 AM and 10 team leaders
- Taking care of AR follow up, Eligibility, EOB-check pull and appeals
- Managed the Client SLA's which includes the aged claims, external Quality, and inventory management
- Received GeBBS Best Process award for OND 2022 Quarter
- Received GeBBS Best Process award for JFM 2023 Quarter
- Received GeBBS Best Process award for JAS 2023 Quarter
- Received GeBBS Best Process award for OND 2023 Quarter
Operations Manager - AAA Surgery Center (Garden State Medical Center) (India) Pvt. Ltd.
(2009-10-01 - 2022-08-26)
Worked as an Operations Manager in a US healthcare-RCM company with Multiple Providers for Pain Management, worked on an E-clinical Software, For Surgery Center worked on Vision Software. For PRC I worked on Streamline MD and Center for Spine and Joint Relief working on E-clinical Software. It was an end-to-end RCM process (Eligibility & Benefit verification, pre-certification, coding, posting, A/R and denial management, patient calling and collection).
- Helped Doctor to set up his office in India with all required equipment along with hiring process
- Managed complete office administration and performed miscellaneous job-related duties whenever assigned
- Responsible for the daily activities of the billing office of an organization
- Transitioned a billing setup into a fully functional RCM operation, by establishing infrastructure, hiring teams, and implementing end-to-end workflows for multispecialty providers (Pain Management, ASC, Spine)
- Standardized end-to-end RCM processes (Eligibility → AR → Patient Collections), reducing process variation and improving operational efficiency across all service lines
- Managed the Organization like supervising employees, attending meetings, motivating employees to improve productivity, and ensuring that all the systems in the company are running smoothly
- Enhanced client satisfaction by establishing proactive communication and issue resolution frameworks, reducing escalations and improving retention
- Maintained excellent relations with clients to generate avenues for more business
- Strengthened revenue realization by optimizing patient collections and statement workflows, improving patient payment conversion rates
- Performed RCA for the potential and chronic complaints along with immediate resolutions
CCE - Accounts Receivable - Medusind Solutions India Pvt. Ltd
(2008-03 - 2009-09)
- Worked as a CSE for 18 months with in-depth knowledge of medical insurance claims procedures and documents
- Through knowledge of medical billing procedures, insurance claims
- Got deep knowledge of the field where I had to get Claim Status from Various insurance Companies on behalf of doctors practicing in US for more than two hundred Clinics related to Dental field
- Worked on QSI software
Senior Executive - Fedora Solutions (India) Pvt. Ltd.
(2006-12 - 2008-03)
- Worked as a Senior Executive for 15 months managing three different projects of Medical Billing and was resolving issues related to Billing, Posting & AR with perfection
- Collaborated with different specialty providers practicing for fields such as: Internal Medicine, Home health, Skilled Nursing Facility, Hospice, Oncology, Sleep lab, Hospital
- Worked as the only Sr. Executive in a team of eight people (Executives) on my project
- Was the main person managing the given work & team
- Had different projects that gave deep knowledge & valuable experience like Patient Demographics, Charge Entry, Payment Posting and Denial Management on different client software such as Medical Manager, Medisoft, eClinicalWorks, Centricity and Mysis
- Could manage all these software's with excellent speed & accuracy
- Trained people under to achieve targets & to increase productivity
