Prasanth Umapathy

Result-driven Revenue Cycle Management (RCM) and Quality Assurance professional with over 4 years of experience optimizing medical billing, claims adjudication, and Charge Entry and Payment posting. Proven track record of auditing 100% of high-volume Institutional and Professional claims while driving continuous process improvement through Kaizen initiatives. Expert in mitigating financial risks, accelerating cash flow, and managing end-to-end RCM operations across multiple healthcare specialties.

Senior Quality Analyst at SAVISTA GLOBAL SOLUTIONS (2022-01 – Present)

Project: MIRA, SEP Adjudication Audit for UHP & Liberty Health Plan

• Driven quality compliance by executing 100% daily audits on the Adjudication Process for both institutional and Professional claims.
• Managed high-volume daily quality checks, auditing 90 correspondence claims and 145 Electronic Funds Transfer (EFT) professional claims per day.
• Authored and delivered critical monthly operational reports like SM Reports, Root Cause Analysis (RCA), and Plan of Action (POA) reports to leadership.
• Conceptualised and implemented 8 Kaizen initiatives that streamlined billing workflows, successfully eliminating timely filing errors and preventing severe financial impacts.

Senior Claim Process at SAVISTA GLOBAL SOLUTIONS (2018-06 – 2022-01)

Project: Medical Billing & Formative | Software: Kareo

• Managed end-to-end RCM cycles specifically optimized for high-volume Radiology providers.
• Executed complex charge entry, demographic validation, payment posting, denial management, and credit balance resolutions.
• Spearheaded the clearing and resubmission of rejected claims directly through the Waystar Clearing House.
• Audited and resolved denial postings derived from daily correspondence and EFTs, executing immediate corrective actions to recover revenue.

BCA – A M Jain College, Meenambakkam (2015 – 2015)

SSLC – JGN Hr Sec School, East Tambaram (2010 – 2010)