Sudha Shah

Healthcare operations and revenue cycle leader with 15+ years of experience leading hospital operations and billing functions across tertiary care, specialty, and government-empanelled hospitals in India. Proven track record of heading end-to-end hospital operations, including OPD/IPD billing, RCM, and government panel management, in high-volume environments processing 4500–5,000+ patient encounters daily. Demonstrated leadership in managing large operational teams and driving performance across ESIC, CGHS, ECHS, and PSU schemes, consistently achieving 90%+ first-pass claim approval and significant TAT reductions.

Recognized for owning revenue cycle performance, strengthening billing accuracy and documentation standards, and reducing claim rejection rates by 25–35% through process governance, audits, and team capability building. Brings strong expertise in NABH compliance, regulatory audits, empanelment strategy, and institutional policy execution, with a focus on aligning clinical, administrative, and financial workflows to improve operational efficiency and revenue realization.

Head Operations & Billing - Supreme Hospital - Faridabad, Haryana

(2025-11 - 2026-04)

Spearheaded full-scope operations and billing functions for a multispecialty private hospital, overseeing OPD and IPD service lines, a team of 18 staff, and all revenue cycle activities including government panel claim management.

• Directed hospital-wide OPD and IPD operations, managing a team of 18 across front office, billing, and care coordination units - aligning team KPIs with hospital efficiency benchmarks targeting 95%+ bed occupancy and <30-minute patient wait times.
• Established structured interdepartmental coordination protocols between clinical teams, nursing, diagnostics, pharmacy, and billing - reducing average discharge-to-billing turnaround by an estimated 20-30%, in line with top-decile hospital benchmarks of <4 hours.
• Introduced process controls and accountability frameworks to improve workflow transparency, reduce escalations, and enhance patient satisfaction across inpatient and outpatient touchpoints.
• Worked in close coordination with Chairman and Vice Chairman on budgeting, operational planning, and performance improvement initiatives - providing data-driven inputs for strategic decision-making.
• Streamlined end-to-end revenue cycle processes covering claim preparation, documentation, approval, and submission across CGHS, ECHS, and PSU panels - targeting TAT improvements of 30-40% over baseline, consistent with industry RCM benchmarks.
• Strengthened billing accuracy and documentation standards, implementing structured pre-billing audits that reduced claim rejection rates and minimized revenue leakage - targeting first-pass approval rates of 90%+ aligned with NABH and government panel norms.
• Managed billing, approvals, and compliance for government cases, ensuring no eligibility or regulatory lapses.
• Independently managed re-empanelment processes for CGHS and PSU panels, ensuring full compliance with updated scheme guidelines, documentation requirements, and inspection protocols.
• Collaborated with specialists and super-specialists to align clinical workflows with billing codes, authorization requirements, and scheme-specific billing protocols - reducing coding errors and improving claim integrity.

Hospital Manager - ESIC Medical College & Hospital - Faridabad, Haryana

(2024-02 - 2025-11)

Managed comprehensive operations of a high-volume government tertiary care hospital serving 5,000+ OPD patients daily and maintaining 900-1100 IPD beds under ESIC - one of India's largest social health insurance schemes covering 13.56 crore beneficiaries.

• Managed operations for 15+ hospital departments. Ensured seamless performance through effective coordination and escalation protocols.
• Supervised pharmacy, stores, linen, housekeeping, dietary, and support services. Ensured all supplies and infrastructure were consistently available for patient care.
• Oversaw bed management, patient flow, and discharge processes, contributing to measurable improvements in patient throughput and reduced average length of stay (ALOS) — benchmarked against ESIC national targets.
• Led patient grievance redressal systems, implementing faster response frameworks that improved complaint resolution TAT by an estimated 40%, elevating patient satisfaction and service delivery standards.
• Conducted regular staff performance reviews, administrative audits, and compliance checks - instituting corrective action plans that improved workforce accountability and departmental efficiency.
• Ensured compliance with ESIC regulations and Labour & Employment directives. Maintained continuous inspection readiness across both administrative and clinical domains.
• Coordinated government audits, external inspections, and policy implementations in alignment with ESIC HQ and Ministry guidelines - achieving zero major compliance findings during tenure.
• Supported NABH accreditation preparation and quality assurance processes, contributing to gap assessments, standard operating procedure (SOP) development, and cross-functional training programs.
• Participated in committees: Infection Control, Mortality Review, HICC, and Quality Assurance. Provided inputs to clinical governance.
• Liaised with ESIC Regional Office, HQ, and Ministry officials for policy execution, statutory reporting, and data submissions - ensuring 100% compliance with reporting deadlines.
• Organized and led internal review meetings, departmental performance discussions, and stakeholder forums tracking action items and ensuring timely resolution of institutional priorities.

Head Administrator - Kashvi Digestive Center - Vadodara, Gujarat

(2007-03 - 2019-06)

Founded and led specialty gastroenterology and liver center. Established operational systems. Managed 12-year tenure in hospital administration, billing, and clinical coordination.

• Led comprehensive hospital administration and daily operations for a specialty care center, managing patient registration, scheduling, billing, MRD, and front-office functions for both OPD and procedure-based IPD services.
• Coordinated billing and finances for gastroenterology (endoscopies, colonoscopies, ERCP) and liver surgeries. Ensured accurate billing and timely collections.
• Enhanced patient flow efficiency. Reduced administrative backlogs. Improved billing-to-collection cycles.
• Ensured regulatory compliance. Maintained accurate records, consent forms, and audit-ready billing files.
• Built and managed a high-performing administrative team, designing onboarding frameworks, training modules, and performance benchmarks aligned with specialty hospital standards.
• Coordinated with visiting consultants, surgical teams, and anesthesiologists for efficient scheduling, resource allocation, and billing of complex GI and liver procedures - sustaining high consultant satisfaction and long-term engagement.
• Drove the center's billing collections growth and patient volume expansion over a 12-year period — contributing to the center's sustained reputation as a leading specialty GI institute in the region.

Master in Business Administration - Healthcare - Institute of Chartered and Financial Analyst of India University (2014 - 2016)

Master of Commerce - MS University, Vadodara (1996 - 1998)

Bachelor of Commerce - MS University (1993 - 1996)