Vikram Jacko

Insurance AR, Denial Management, and Medical Billing Specialist with 4+ years of true end-to-end healthcare revenue cycle experience — eligibility and benefits verification, provider credentialing, claims filing and documentation, payer requirement research for timely adjudication, claims followup, denial resolution, reprocessing, appeals, coding-based denial and error-trend analysis, payment posting, and insurance/patient refunds — gained across Availity, UHC, Optum, Medicare, Medicaid, Office Ally, TRICARE, Payspan, Zelis, and Echo Health, with strong hands-on expertise in AdvancedMD (AMD). Early-career experience at a startup RCM environment required owning the full billing lifecycle personally, building a rare breadth of knowledge spanning CPT/procedure coding, ICD-9 and ICD-10 diagnosis coding, coding-tool-based denial root-cause analysis, and hospice/SNF claim resolution. Confident outbound AR caller with fluent, professional English communication and an investigative, self-starting mindset for running down claim problems using data.

An effective multitasker who juggles multiple client accounts and competing deadlines without losing accuracy, with a high personal quality bar balanced by practical judgment on where speed matters more than polish — done is better than perfect, but never at the expense of accuracy that counts. Reduced AR aging by 45% and improved collections efficiency by 40% through proactive follow-up and process discipline. Positive, cooperative team player with individuals at every level of an organization — from front-line coding/billing staff to strategy & operations leadership — experienced in managing multiple clients and specialties simultaneously, communicating coverage/guideline changes and denial trends to internal teams and customers alike, and consistently helping clients achieve stronger financial outcomes.

Reimbursement Specialist - Total RCM

(2025-05)

• Manage end-to-end insurance AR follow-up across multiple client accounts and competing deadlines, initiating outbound calls to insurance carriers and confidently negotiating with payer representatives to obtain accurate claim status, denial reasons, and resolution steps
• File claims and corrected claims with appropriate supporting documentation attached, and research payer-specific requirements to support timely adjudication and reduce avoidable denials
• Investigate and resolve denials through reprocessing, corrected claims, and well-documented appeals — successfully converting long-pending aged claims into completed payments
• Process incoming and outgoing payer/patient correspondence, verifying, adjusting, and updating AR records in line with correspondence received
• Review EOBs/ERAs and accurately tally payment posting entries, identifying and resolving discrepancies to ensure clean reconciliation
• Navigate Availity, UHC, Optum, Medicare, Medicaid, Office Ally, TRICARE, and payment portals (Payspan, Zelis, Echo Health) for eligibility, claim status, and remits
• Identify recurring denial and error trends and help facilitate communication of findings to billing/coding teams; collaborate as a positive, reliable team player at every level of the organization, proposing process improvements and driving open issues to positive closure; recognized for consistent accuracy and quality across multiple client portfolios

AR Senior Executive - Global Healthcare Billing Partners Pvt Ltd - Chennai, India

(2024-06 - 2024-12)

• Handled denial resolution and eligibility/benefits verification for a commercial and managed-care payer mix across multiple client accounts, using strong analytical review of EOBs/ERAs
• Negotiated directly with insurance representatives via outbound calls to resolve denials and expedite claim reprocessing
• Tracked payer coverage and billing-guideline updates and communicated relevant changes to the internal team and client stakeholders to keep claim submissions current
• Used Excel extensively for AR aging analysis, trend tracking, and management reporting; proposed alternate resolution paths for escalated accounts, reducing revenue leakage
• Maintained detailed, HIPAA-compliant documentation and collaborated with internal teams to resolve discrepancies and help clients achieve stronger collections outcomes

AR Caller (End-to-End Process) - Fidelitas RCM Pvt Ltd - Chennai, India

(2022-05 - 2024-06)

Worked in a startup RCM environment that required owning the billing process end-to-end personally — gaining hands-on exposure across nearly every stage of the revenue cycle rather than a single narrow function

• Performed patient eligibility and benefits verification prior to service, and supported provider credentialing and payer enrollment tasks
• Applied working knowledge of CPT procedure codes and ICD-9/ICD-10 diagnosis codes to review claims and strengthen denial and appeal accuracy
• Used coding-analysis tools to identify the probable root cause of coding-related denials, improving first-pass resolution rates
• Resolved hospice and SNF (Skilled Nursing Facility) claims, applying specialty-specific billing and filing rules
• Selected for a special project reviewing and resolving insurance and patient refund cases, requiring keen analytical judgment to validate overpayments and process accurate refunds
• Initiated proactive outbound calls to insurance companies and providers across Medicare, Medicaid, and commercial payers, communicating fluently and professionally to secure timely claim processing
• Identified, investigated, and resolved denied or underpaid claims, ensuring timely resubmission or appeal within compliance and timely-filing deadlines
• Used AdvancedMD and Practice Suite to manage and resolve claims; prepared regular AR status, aging, and collections reports

Bachelor of Engineering - Mechanical Engineering - Loyola Institute of Technology (2017 - 2021)

Class XII (HSC) - Government Model Hr. Sec. School (2016 - 2017)

Class X (SSLC) - Government Model Hr. Sec. School (2014 - 2015)