Todkari Avinash

Results-driven US Healthcare Revenue Cycle Management (RCM) Specialist with proven expertise across the complete end-to-end medical billing cycle, from upfront insurance verification and charge posting to claims processing, claim follow-up, and denial management. Skilled in navigating Medicare, Medicaid, and Commercial payer platforms to accelerate cash flow, resolve complex denials, file compliant appeals, and minimize aged accounts receivable. Recognized for maintaining high claim submission accuracy and strict compliance with HIPAA and US healthcare guidelines.

Medical Billing Specialist at SSK Solutions Inc (2020-02 – Present)

• Oversee the full end-to-end medical billing and collections cycle for assigned US provider accounts to ensure maximum, prompt reimbursement.
• Conduct daily claims scrubbing, charge posting, and electronic submissions, maintaining clean-claim rates above industry standards. Perform rigorous AR follow-up on outstanding, aged, and delinquent claims using payer web portals.
• Analyze claim rejections and denials to perform root cause analysis (RCA), logging trends and deploying corrective actions to prevent recurring errors.
• Draft and submit comprehensive appeals and payer reconsiderations with clinical documentation and medical necessity proof to recover denied revenues.
• Review and interpret Explanation of Benefits (EOB) and Electronic Remittance Advices (ERA) to post payments and reconcile contractual write-offs.
• Ensure every client account adheres strictly to HIPAA privacy requirements and billing compliance mandates.

Bachelor Of Science – RamKrishna Paramhansa College