Manager - AGS Health Pvt Ltd - TPT, AP
(2024-08)
- Successfully managed projects with team of 85 FTE's, & 5 Team leads
- Adhere to Service Level Agreements/Bench Marks.
- Production planning and control, Process Monitoring, Assignment and review of workloads.
- Care Management: Involved in team management, reporting and analytics for various wellness programs, including production support and client management.
- Worked on identification and analysis of outliers based on the available payer claims data.
- Provided ad-hoc training and support in various claims based on scenarios.
- To prepare Weekly, Monthly reviews by preparing Power Point presentations showing the exact development/efficiency of the Project and suggest/advise changes within process to retrieve better outputs.
Healthcare Billing Manager - Precistat IT Solutions PVT Ltd. - VSKP A.P.
(2017-07 - 2023-12)
- Provide strategic guidance to a team consisting of over 75 members including 2 Team leaders and 1 Assistant Manager.
- Ensure customer policies, procedures and contractual agreements are consistently met from an operational perspective and ensure realistic and practical commitments are made to clients.
- Managed complete P&L for the account with the focused approach on achieving operations metrics.
- Development of 'best practices' policies and procedures to enhance billing, reimbursement and collection activities and ensure compliance with all regulatory, legal, contractual and accreditation requirements.
- Coordinating with a team of local candidates giving on-job-training in the US Healthcare process related to accounts receivables.
- Handling client meetings, advising on process improvement plans and working on special projects to improve inflow of revenue.
- Care Management - Involved in team management, reporting and analytics for various wellness programs, including production support, client management.
- Organized training for new joiners in an introduction course of medical coding and coding related denials.
- Fulfilled the client's aspiration in terms of reducing the AR Days and increasing the collections from 17% to 35%.
- Controlled 3 -5 % attrition level per quarters
Billing Manager - IDEAFINANCEMED LLC., (ARMD Now Billing Solutions) - Xi'an City, China
(2014-12 - 2017-07)
- Involved in a project on Population Health, HEDIS Analytics
- Making the China team able to handle new process and existing process by giving them training, preparing Check list, SOPs and other process to standardize and improve quality of the process
- Responsible to process various types of offshore transitions of RCMS process.
- Responsible to handle end to end process of RCMS starting from credentialing to Credit Balance.
- Giving support to IT team to develop their own practice management system
Team Manager - Sutherland Healthcare Solutions. - Hyd. Telengana
(2007-03 - 2013-09)
- Handled Payment posting (ERA & Manual), Account receivables (AR-RCM), Credit balance review (patient and insurance).
- Involved in analysis and identification of overpaid claims, post payment.
- Provided ad-hoc consulting in various claims overpayment projects.
- Facilitated solution at the front - end and billing department to reduce inflow of denials.
- Interacted with clients with regard to various projects of self-pay and bad debt collections.
- Manage team performance, time management. Reviewing Production and Quality report, Leave tracker status of the team.
- Giving training to the team for common and uncommon scenario of the process.
- Analyze results and trends to develop individualized coaching plans to improve performance
- Giving feedback to the team and individuals who are under Focus and Performance improvement plan.
- Generating weekly project management dash board, client dash board escalation to client.
- Presenting analysis report weekly and monthly dashboard to managers.
Senior Executive - Easymed Inc. - Hyd. Telengana
(2005-08 - 2007-02)
- Patient demographics entry (Patient registration), Charge entry, Posting of all payments and adjustments.
- Generation and mailing of paper claims and patient statements. Accounts Receivable analysis and management.
- Insurance verification and Insurance and patient follow-up.
- Specially trained in AR Management to help in reducing outstanding AR and maximize collections.
Senior Executive - iSpace SoftwareTech. Ltd. - Hyd. Telengana
(2003-11 - 2005-07)
- Worked for the process of Provider Directory Management, Claims Re- pricing, CMS-1500 claim Processing, Application Enrollment process.
- Responsible to allocation of claims to a specific Group and making sure of their completion at the EOD with quality.
- Conducted regular quality sessions to the group.
