Sharique Akhtar

Over eleven years of extensive experience in the US healthcare industry, specializing in Revenue Cycle Management (RCM), AR Follow-up, Denial Management, and Authorization across organizations including R1RCM, Genpact India Pvt Ltd, and Concentrix. Proven ability to work under pressure and meet critical deadlines while remaining flexible to changing requirements and driving cross-functional team interactions. Self-driven professional with a strong focus on process enhancement, cost reduction, and organizational goal achievement; recognized for stepping up as acting team lead in the absence of Team Lead or Assistant Manager.

Skilled in mentoring junior analysts, managing day-to-day team escalations, and maintaining operational continuity during leadership gaps.

Senior Analyst - R1RCM

(2018-04)

US Healthcare – AR Denial Follow-up / Revenue Cycle Management (RCM)

• Review and analyse denied claims from commercial, government, and managed care payers to identify root causes, denial trends, and categorize by type (clinical, coding, eligibility, authorization, timely filing) for appropriate corrective action.
• Initiate timely appeals by gathering clinical notes, authorization records, and supporting documentation; coordinate with clinical and coding teams to resolve complex denials and prevent recurrence.
• Monitor payer-specific denial patterns, escalate systemic issues to leadership, and ensure compliance with payer appeal timelines and contractual obligations to minimize revenue leakage.
• Utilize Epic, Athena, Meditech, and Cerner to track, update, and manage denied claim statuses and appeal outcomes.
• Manage aging AR buckets (30/60/90/120+ days), prioritizing follow-up based on outstanding balances and payer timelines; conduct proactive outreach with insurance carriers via phone, payer portals, and correspondence.
• Identify and resolve claim issues including incorrect patient demographics, billing errors, missing information, and duplicate submissions; verify EOBs, ERAs, and remittance advices to ensure accurate claim adjudication.
• Initiate adjustments, write-offs, or refunds per payer contracts and internal policies; navigate Epic, Athena, Meditech, and Cerner to retrieve claim history, update account statuses, and record follow-up actions.
• Prepare and maintain daily, weekly, and monthly AR and denial reports; track KPIs including denial rate, clean claim rate, first-pass resolution rate, and days in AR to support management decision-making.
• Generate trend analysis reports to identify payer-specific issues, drive data-driven process improvements, and compile escalation logs and resolution summaries for leadership and process audits; document all findings in Epic, Athena, Meditech, or Cerner.
• Serve as the primary escalation point for complex accounts, high-priority claims, and unresolved payer disputes; assess urgency and financial impact, and take decisive action to resolve or route issues to minimize AR aging.
• Mentor and guide junior analysts on denial codes, payer-specific rules, appeal procedures, and system tools (Epic, Athena, Meditech, Cerner); conduct quality audits and provide constructive feedback to improve team accuracy and productivity.
• Step in to manage daily team operations — assigning workflows, monitoring queues, and ensuring SLA adherence — in the absence of the Team Lead or Assistant Manager, while facilitating team briefings and stakeholder communication.
• Identify recurring escalation patterns and collaborate with leadership to implement preventive process improvements.

Process Associate (US Healthcare Process) - Genpact India Pvt Ltd

(2015-03 - 2017-12)

• Processed and verified medical claims for US healthcare clients; verified patient eligibility, insurance coverage, and benefit details to ensure accurate billing submissions and timely clean claim submission within payer deadlines.
• Supported claim entry, charge posting, and basic rejection resolution using Epic, Athena, Meditech, and Cerner; identified and resolved eligibility discrepancies to reduce denial volumes.
• Logged and tracked interactions and claim statuses in the CRM system; escalated unresolved or complex issues to senior team members and ensured complete, accurate documentation of all activities.
• Maintained daily activity logs, performance trackers, and assisted in compiling weekly summary reports on claim status and query resolution for supervisor review.
• Supported peers on process queries, system navigation (Epic, Athena, Meditech, Cerner), and payer guidelines; assisted with queue management during high-volume periods and contributed to team briefings and knowledge-sharing sessions.

Associate - Concentrix

(2014-01 - 2014-10)

Healthcare Billing Support (US Healthcare Process)

• Verified patient eligibility, insurance coverage, and benefit details; supported claim entry and charge posting using Epic, Athena, Meditech, and Cerner, and assisted in resolving basic claim rejections and eligibility discrepancies to reduce denial volumes.
• Coordinated with senior team members to ensure timely submission of clean claims within payer deadlines.
• Maintained daily activity logs and performance trackers; assisted in compiling weekly summary reports and supported peers on system navigation and process queries during high-volume periods and team briefings.

Bachelor of Commerce - Commerce - Vinoba Bhave University, Hazaribagh (2004 - 2007)

Master of Commerce Distance - Commerce - Periyar University Salem, Tamil Nadu (2007 - 2009)

ADBM and PGDBM (Hybrid) - Marketing and Supply Chain Management - Wellingkar Institute of Management, Mumbai (2016 - 2018)