Sabarish Nataraj
Medical Billing Specialist
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About
Detail-oriented AR Analyst and QA Auditor with extensive experience in US medical billing and Revenue Cycle Management (RCM). Skilled in complex claims and appeals, audit management, and quality assurance with a deep understanding of medical coding (ICD-10, CPT, HCPCS) and HIPAA compliance. Proven ability to analyze accounts receivable, enhance revenue streams, and mentor junior staff. Seeking to apply expertise in a challenging role to improve billing accuracy and financial performance.
Experience
Quality Assurance Auditor (QA Auditor) - Wave online - Coimbatore
(2025-06 - 2026-04)
- Conducted comprehensive internal audits of medical claims and documentation to ensure adherence to payer policies and regulatory standards.
- Managed audit processes to maintain compliance and identify areas for process improvement within the revenue cycle.
- Leveraged in-depth knowledge of US medical insurance, including provider and payer claims processes, to ensure accuracy and efficiency.
Senior specialist provider reimbursement - Logixhealth solutions - Coimbatore
(2018-07)
- 1-9 years of experience in medical billing or revenue cycle management
- Technical Knowledge: Proficiency in medical coding, insurance policies (Medicare, Medicaid, Commercial), and billing software.
- Analytical Skills: Ability to identify trends in claim denials and develop corrective action plans.
- Communication: Strong interpersonal skills for interacting with insurance representatives, physicians, and patients.
AR Calling/AR Analyst - Logixhealth solutions - Coimbatore
- Analyzed and managed accounts receivable, implementing strategies to minimize payment delays and optimize revenue collection.
- Investigated and resolved denied, rejected, or underpaid claims through formal appeals processes.
- Reviewed medical documentation for coding accuracy (ICD-10, CPT, HCPCS) and ensured compliance with insurance contracts.
- Mentored junior staff, assisted with onboarding, and served as a subject matter expert on billing software and regulations.
(SME) Subject Matter Expert - Logixhealth solutions - Coimbatore
(2021-01)
- Final Point of Escalation: Serves as the ultimate authority for resolving high-level billing concerns and complex claim scenarios.
- Systemic Problem Solving: Identifies and corrects errors caused by system setup or process gaps, often collaborating with technical staff like system administrators.
- Denial Management: Conducts root cause analysis (RCA) for denials and underpayments to implement corrective actions.
- Primary Knowledge Resource: Acts as the "go-to" person for payer-specific rules (e.g., Medicare, Medicaid, HMO/PPO), claim adjudication, and coding updates.
- Mentoring & Development: Provides real-time guidance and structured training sessions for Level 1 and Level 2 billing support staff.
- Standardization: Develops job aids, standard operating procedures (SOPs), and process documentation to ensure consistent work across teams.
- Trend Analysis: Analyzes revenue and inventory trends to identify bottlenecks and propose efficiency measures.
- Automation Support: Works with engineering and product teams to translate billing logic into rule sets for AI and automation.
- Quality Auditing: Performs internal and external quality audits on claims to ensure precision and reduce rework.
- Stakeholder Liaison: Bridges communication between front-end operations, billing reps, and client Accounts Receivable (AR) teams.
- Regulatory Compliance: Ensures all billing activities strictly adhere to HIPAA regulations, state programs, and internal standards.
- Client Interaction: Participates in client meetings and audits to provide expert recommendations and billing outcomes.
Education
BSC - Computer science - TSA, Bharathiyar University (2013-06)
HSC - Computers science Accountancy - Government higher secondary school Manjoor (2013-06)