Suresh Kumar

US Healthcare Revenue Cycle Management (RCM) professional with 10+ years of experience in Payment Posting and Cash Applications. Expertise in manual and electronic posting of insurance, patient, ACH, and credit card payments with strong knowledge of Medicare and Medicaid EOB interpretation.

Proven Subject Matter

Expert (SME) in offshore transitions, SOP creation, team leadership, quality management, and productivity control in high-volume medical billing environments. Demonstrated ability to maintain 95%+ quality while meeting aggressive SLA and turnaround time requirements.

SME - Unislink - Hyderabad

(2024-10)

• Leads and mentors a team of 10 Payment Posting associates to consistently meet productivity, SLA, and quality targets.
• Manages daily operational activities including work allocation, attendance monitoring, shrinkage control, and volume delivery.
• Supports offshore transition projects by assisting with process migration, agent training, and operational stabilization.
• Develops and maintains Standard Operating Procedures (SOPs) and process documentation for assigned workflows.
• Maintains 95%+ quality scores during client certifications and internal quality audits.
• Conducts weekly quality calibrations and operational review meetings with internal and client stakeholders.
• Provides continuous feedback, root-cause analysis, and corrective coaching to improve agent performance.
• Prepares and presents weekly and monthly performance reports using MS Excel and PowerPoint.
• Tracks rework trends and implements corrective actions to improve first-pass yield and reduce error rates.
• Reviews unapplied patient payment accounts and accurately posts missing payments to appropriate Date of Service (DOS).
• Interprets EOBs and remittance advice to resolve posting discrepancies.
• Applies insurance, patient, ACH, and credit card payments while ensuring proper contractual adjustments.
• Supports refund processing and daily cash reconciliation activities to ensure financial accuracy

Credit Balance Specialist - Unislink

(2021-08 - 2024-09)

• Reviewed and analyzed patient and insurance credit balances to identify overpayments and duplicate payments.
• Investigated account discrepancies and determined appropriate resolution based on payer and client guidelines.
• Processed refunds and adjustments for insurance carriers and patients in a timely manner.
• Researched payment history, EOBs, and ERA records to validate credit balances.
• Coordinated with billing, payment posting, and AR teams to resolve outstanding credit balance accounts.
• Maintained accurate documentation of refund requests, adjustments, and account resolutions.
• Ensured compliance with HIPAA regulations and organizational policies during credit balance review processes.
• Performed account reconciliation and root cause analysis to prevent recurring credit balance issues.
• Managed aging credit balance reports and prioritized accounts for resolution.
• Contributed to revenue cycle efficiency by reducing unresolved credit balance inventory.
• Processed and posted insurance and patient payments accurately using ERA (Electronic Remittance Advice) and EOB (Explanation of Benefits).
• Reviewed and reconciled payment batches to ensure accurate account balances and reimbursement posting.
• Analyzed payment variances, underpayments, denials, and adjustments, and escalated issues for resolution.
• Performed credit balance reviews and coordinated refund processing according to payer guidelines.
• Posted contractual adjustments, write-offs, and patient responsibility amounts accurately.
• Maintained productivity and quality standards while handling high-volume payment posting activities.
• Worked closely with Accounts Receivable (AR) and Billing teams to resolve payment discrepancies.
• Conducted account reconciliation and ensured compliance with revenue cycle management processes.
• Assisted in training and supporting team members on payment posting procedures and quality standards.
• Ensured compliance with HIPAA regulations and organizational policies.

Senior Executive – Payment Posting - Unislink

(2018-01 - 2021-07)

• Processed and posted insurance and patient payments accurately using ERA (Electronic Remittance Advice) and EOB (Explanation of Benefits).
• Reviewed and reconciled payment batches to ensure accurate account balances and reimbursement posting.
• Analyzed payment variances, underpayments, denials, and adjustments, and escalated issues for resolution.
• Performed credit balance reviews and coordinated refund processing according to payer guidelines.
• Posted contractual adjustments, write-offs, and patient responsibility amounts accurately.
• Maintained productivity and quality standards while handling high-volume payment posting activities.
• Worked closely with Accounts Receivable (AR) and Billing teams to resolve payment discrepancies.
• Conducted account reconciliation and ensured compliance with revenue cycle management processes.
• Assisted in training and supporting team members on payment posting procedures and quality standards.
• Ensured compliance with HIPAA regulations and organizational policies.

Charge Entry / Medical Billing Executive - Unislink

(2015-07 - 2017-12)

• Entered and reviewed patient charges accurately based on medical documentation, superbills, and encounter forms.
• Verified CPT, ICD-10, and HCPCS codes before charge submission to ensure billing accuracy.
• Posted professional and facility charges into the billing system in a timely manner.
• Reviewed charge batches and corrected errors to minimize claim rejections.
• Ensured compliance with payer guidelines and healthcare billing regulations.
• Coordinated with providers and coding teams to resolve charge discrepancies.
• Maintained productivity and accuracy standards while processing high volumes of charges.
• Performed charge audits and reconciliations to ensure complete revenue capture.
• Assisted with claim generation and submission following charge entry.
• Supported Revenue Cycle Management (RCM) processes by ensuring accurate charge capture and billing.

B.Com - Vijetha Degree College (2012)

Intermediate - Gowtham Junior College (2008)

SSC - Kabitha High School (2006)