Rajeev Ranjan

Detail-oriented Healthcare Revenue Cycle Management (RCM) professional with several years of experience in medical billing, accounts receivable follow-up, denial management, and insurance claim resolution. Skilled in handling government and commercial payers, identifying payment discrepancies, and ensuring compliance with billing regulations. Known for strong analytical skills, accuracy, and effective communication.

Senior Client Partner - Access Healthcare Services Pvt. Ltd.

(2021-04)

EMR Systems Experience: Athenahealth, Debra, eClinicalWorks (eCW), NextGen, CareCloud, AdvancedMD, Allscripts & Ethizo

• Performed AR follow-up on outstanding insurance claims for radiology services.
• Contacted insurance companies to determine claim status and resolve unpaid or partially paid claims.
• Reviewed EOBs and ERAs to identify denial reasons, payment discrepancies, and underpayments.
• Submitted corrected claims, appeals, reconsiderations, and medical records for denied services.
• Worked aging reports to reduce accounts over 30, 60, 90, and 120 days.
• Verified patient eligibility, benefits, and authorization requirements before claim submission.
• Investigated coding-related denials involving CPT, ICD-10-CM, modifiers, and medical necessity.
• Coordinated with coders, providers, and authorization teams to resolve documentation deficiencies.
• Processed claim adjustments, write-offs, contractual adjustments, and balance transfers according to payer guidelines.
• Maintained productivity and quality metrics while meeting daily AR targets.
• Documented all payer interactions accurately in the billing system.
• Ensured compliance with HIPAA regulations and payer-specific billing requirements.

Bachelor of Science - B.Sc. - Patna University, B.N. College, Patna

Intermediate - B.I.E.C - J.J. College, Koderma

Matriculation - B.S.E.B - Koderma High School, Koderma