Arpan Kumar Mohanty
Medical Billing - Reimbursement Specialist
Bengaluru,KA
Summary
As an experienced Team Lead and SIX SIGMA Green Belt holder, I worked on both sides of the coin (Operations and Quality). I am an analytical Lead with extensive knowledge of Healthcare RCM. Successful at solution-oriented problem-solving and dedicated to customer satisfaction. Adept at staying motivational and positive in high-demand situations.
Overview
9
9
years of professional experience
18
18
years of post-secondary education
2
2
Certificates
Work History
Process Lead
Tharworx PVT LTD
Bangalore, Karnataka
12.2020 - Current
- Oversee & offer floor support to associates
- Demonstrate a commitment to supporting a productive, positive work environment
- Assist in client issues and trends by escalating information to supervisors and customers
- Maintain sincere interest in providing stellar customer care
- Understand customer needs, determine the appropriate course of action to meet those needs
- Exercise independent thinking in meeting customer needs
- Combine knowledge of medical billing, good work ethic, effective time management skills and human relations skills to meet performance standards and positively influence the client's image
- Effectively deal with complex customers
- Experience in handling 50+ FTEs and multiple customers
- Maintained open communication by presenting regular updates on project status to customers.
- Tracked project and team member performance closely to quickly intervene in mistakes or delays.
- Recruited and oversaw personnel to achieve performance and quality targets.
- Verified quality of deliverables and conformance to specifications before submitting to clients.
- Also handled Recruitment, appraisals and attrition
Quality Analyst
Tharworx PVT LTD
Bangalore, Karnataka
07.2020 - 11.2021
- As a Green Belt SIX SIGMA holder, I understand and define, take measures like RCA and POA to control
- Training and development for newly joined employees
- Acts as authority in absence of team lead and assures smooth floor operations and customer calls
- Provide inputs on the process flow to the customer
- Prepare weekly QPR report and share it with the team
- Work closely with the low performing team member and constant training till they achieve the SLA
- PIP & take action on continuous low performing employees
- Prepare and share the statistical reports with the team. Ex: Pareto Chart, user error contribution and categories
Senior Reimbursement Specialist
ACN Healthcare Services PVT LTD
Bangalore, Karnataka
05.2019 - 06.2020
- Experience in claims & appeals follow up, correspondence, obtaining prior authorizations
- Work on denials and submit corrected claims if required
- Monitored and documented accounts receivable trends and account-specific profitability.
- Created documents in accordance with payer guidelines and submitted to appropriate parties.
- Adhere to client protocols and SLAs
- Awarded for highest production and 100% quality
- Assist QA in auditing
Executive AR
Ionidea Enterprise Sol PVT LTD
Bangalore, Karnataka
08.2017 - 02.2019
- AR, Claims and appeals follow up
- Worked on front end clearing house rejections and correct them and submit
- Submit appeals by preparing the cover sheet and attach MR/POTF for their respective denials.
- Assisted team members to achieve a common goal
- Follow SOP and client protocols
- Identify trends and report it to our supervisor
- Assisting the leads in preparing production reports
- Sending and getting reports from coding team on coding related denials and submit corrected claim
Executive AR
Omega Healthcare Services PVT LTD
Bangalore, Karnataka
08.2016 - 07.2017
- AR & Claims follow up
- Working on claim denials and take appropriate step to get back the payment
- Provider Credentialing - Helping provider to participate in insurance and obtaining CLIA numbers
- Achieve daily targets and quality
Associate AR
Infojen Technologies PVT LTD
Bhubaneswar, Odisha
08.2013 - 03.2016
- AR & Claims follow up
- Working on claim denials and take appropriate step to get back the payment
- Achieve daily targets and quality
Education
Bachelor of Technology - Electrical, Electronics And Communications Engineering
Siksha 'O" Anusandhan University
Bhubaneswar 09.2009 - 10.2013
Higher Secondary Education in Science - Science, Maths, Computer Science
Jupiter +2 Science College
Bhubaneswar 08.2007 - 05.2009
Secondary Education - 10th - Science, Maths, Social Science, English
DAV Public School
Bhubaneswar 03.1995 - 05.2007
Skills
Decision Making
Time Management
SIX SIGMA Green Belt in quality
Flexible and Adaptable
Team Player
Planning and Coordination
Analytical and Critical Thinking
Teambuilding
MS Office
Certification
Six SIGMA Green Belt
Timeline
Six SIGMA Green Belt
12-2021
Process Lead
Tharworx PVT LTD
12.2020 - Current
Quality Analyst
Tharworx PVT LTD
07.2020 - 11.2021
Senior Reimbursement Specialist
ACN Healthcare Services PVT LTD
05.2019 - 06.2020
Executive AR
Ionidea Enterprise Sol PVT LTD
08.2017 - 02.2019
Executive AR
Omega Healthcare Services PVT LTD
08.2016 - 07.2017
Java and SQL Coder
10-2015
Associate AR
Infojen Technologies PVT LTD
08.2013 - 03.2016
Bachelor of Technology - Electrical, Electronics And Communications Engineering
Siksha 'O" Anusandhan University
09.2009 - 10.2013
Higher Secondary Education in Science - Science, Maths, Computer Science
Jupiter +2 Science College
08.2007 - 05.2009
Secondary Education - 10th - Science, Maths, Social Science, English
DAV Public School
03.1995 - 05.2007
Personal Details
Father's Name - Ramakanta Mohanty
Mother's Name - Sanjukta Mohanty
Gender - Male
Date of Birth - 26th March 1991
Languages known - English, Hindi, Oriya
Personal Details
Father's Name - Ramakanta Mohanty
Mother's Name - Sanjukta Mohanty
Gender - Male
Date of Birth - 26th March 1991
Languages known - English, Hindi, Oriya