Abdul Rehman M
Tiruppur
Summary
Experienced Accounts Receivable and Denial Management Specialist with over 7 years of expertise in managing AR follow-up, claim adjudication, and denial resolution processes within the US Healthcare sector. Skilled in claims re-filing, payer communication, and denial prevention strategies to minimize revenue loss and enhance operational efficiency. Adept at analyzing payer trends, identifying root causes of claim denials, and implementing corrective actions. Experienced in training and leading teams, along with providing quality assurance and process improvements.
Overview
9
9
years of professional experience
Work History
Senior Accounts Receivable - US Health Care
Savista Global Solutions
Chennai
09.2024 - Current
- Monitored submitted dental insurance claims to ensure timely payments and actively followed up on outstanding balances across multiple dental offices.
- Tracked claim adjudication statuses, ensuring accurate and timely reimbursement from insurance payers.
- Contacted insurance companies to inquire about claim statuses, payment delays, and resolve issues related to delayed, underpaid, or incomplete payments.
- Re-filed claims rejected due to errors or missing documentation, ensuring proper correction and successful resubmission.
- Prevented and resolved claim denials by identifying root causes, implementing corrective actions, and improving claim accuracy.
- Analyzed denial trends to minimize revenue loss and optimize the overall revenue cycle process.
- Managed the appeals process, including drafting and submitting appeals or corrected claims to recover denied reimbursements.
- Utilized a variety of Practice Management Systems (PMS) including Eaglesoft, Dentrix, OpenDental, WinOMS, Fuse, Carestack (cloud-based), Denticon, and DSN to streamline billing and AR processes across multiple practices.
- Served as a Quality Auditor, reviewing completed production files to ensure accuracy, compliance, and completeness prior to client submission.
- Ensured adherence to production quality standards, significantly reducing rework and improving client satisfaction through detailed audits and constructive feedback.
Senior Process Executive - US Health Care
Cognizant
Chennai
04.2022 - 09.2024
- Worked in EDI Rejections & Follow-up Accounts.
- Analyzed claims and took appropriate action based on the client's instructions.
- Identified payer trends and addressed multiple claims with similar scenarios by taking a single action.
Accounts Receivable Executive
NTT DATA
Chennai
05.2020 - 04.2022
- Worked on Follow-up Accounts aged 180+ days in both physician and hospital billing.
- Analyzed claims and took appropriate action based on the client's SOP.
- Identified payer trends and addressed multiple claims with similar scenarios by taking a single action.
- Provided training and support to a team of 20+ members, resolving doubts and clarifications.
- Allocated work orders, consolidated production sheets on a daily, weekly, and monthly basis, and submitted MTD reports to the manager.
- Acted as Quality Analyst for around 1 year, providing daily quality reports.
Senior Client Executive
Medusind Solutions
Chennai
07.2018 - 04.2020
- Worked on unpaid/unresolved ADA claims and followed up with insurance to secure payment.
- Analyzed claims and took appropriate action based on client instructions.
- Identified payer trends and addressed multiple claims with similar issues by taking a single action.
- Probed insurance companies to identify the root cause for claim denials.
Customer Service Executive
Colossus BPO Pvt. Ltd.
Chennai
09.2016 - 06.2018
- Reported as a Customer Support Executive for a back-end semi-voice process.
- Made calls to customers to validate data and create customer profiles in the Sulekha site.
- Managed incoming emails from customers, support teams, and vendors.
- Coordinated with the branch sales team regarding customer issues and service requests.
- Took responsibility for personal performance improvement and meeting deadlines.
- Coordinated with technical and product teams for application development and performance updates.
Education
Bachelor of Technology - Mechanical Engineering
Periyar Maniammai University
Thanjavur, TN01.2016
12th Standard - Biology Group
Nanjappa Boys Govt Higher Secondary School
Tiruppur01.2012
10th Standard -
Nanjappa Boys Govt Higher Secondary School
Tiruppur01.2010
Skills
- Problem-solving
- Claims follow-up
- Denial management
- Claim resubmission
- Revenue cycle management
- Time management
- Team building
- Quality auditing
- Problem solving
- Trend analysis
- Attention to detail
- Training and development
- Teamwork and collaboration
- Customer service
Personal Information
- Father's Name: MANSOOR BASHA
- Mother's Name: SHARMILA
- Date of Birth: 08/04/1995
- Gender: Male
- Nationality: Indian
Languages
- Urdu
- Tamil
- English
- Hindi
Timeline
Senior Accounts Receivable - US Health Care
Savista Global Solutions
09.2024 - Current
Senior Process Executive - US Health Care
Cognizant
04.2022 - 09.2024
Accounts Receivable Executive
NTT DATA
05.2020 - 04.2022
Senior Client Executive
Medusind Solutions
07.2018 - 04.2020
Customer Service Executive
Colossus BPO Pvt. Ltd.
09.2016 - 06.2018
Bachelor of Technology - Mechanical Engineering
Periyar Maniammai University
12th Standard - Biology Group
Nanjappa Boys Govt Higher Secondary School
10th Standard -
Nanjappa Boys Govt Higher Secondary School
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