ABHIJEET BHAME
Quality Analyst-Healthcare RCM
Pune
Summary
Payment Posting Team Lead leading daily payment posting, batch balancing, and reconciliation for US healthcare billing operations. Guides team members through EOB review, discrepancy resolution, and denial follow-up while keeping posting sheets and records audit-ready. Builds consistency through training on client updates, process changes, and month-end closure requirements.
Overview
1
1
Language
10
10
years of professional experience
Work History
Quality Assurance – Payment Posting
TruBridge Healthcare Solutions Pvt. Ltd.
10.2024 - Current
- Ensuring all posting activities are completed before month-end closure.
- Performing payment posting, auditing, and reconciliation with high accuracy.
- Managed denial management and insurance follow-up activities to minimize claim rejections.
- Interpreting Explanation of Benefits (EOBs) and resolving discrepancies.
- Maintained accurate records of electronic and paper claims.
- Ensured daily batch balancing and submission of posting sheets, contributing to accurate financial records.
- Provided second-level support to team members, resolving process-related queries and enhancing knowledge sharing.
- Conducting training sessions for new hires and updating teams on client/process changes.
Senior Associates – Payment Posting
TruBridge Healthcare Solutions Pvt. Ltd.
09.2021 - 10.2024
- Posted payments, audited transactions, and reconciled accounts to ensure accuracy in financial records.
- Ensured daily batch balancing and submitted posting sheets to maintain accurate financial records.
- Ensuring all posting activities are completed before month-end closure.
- Managed denial management and conducted insurance follow-up to resolve outstanding claims efficiently.
- Interpreting Explanation of Benefits (EOBs) and resolving discrepancies.
- Tracked electronic and paper claims for timely processing, minimizing delays in revenue cycle.
- Handling US Healthcare, Home Health, and Hospice Billing processes.
- Provided second-level support to team members, enhancing resolution of process-related queries.
- Led training sessions for new hires and provided updates to teams on client and process changes to enhance knowledge.
Claim associates
3Gen consulting service LLP
08.2020 - 09.2021
- Processed healthcare claims with timely follow-up on insurance activities, facilitating resolution of claims.
- Maintained accurate patient and billing records, supporting seamless claims management operations.
- Assisted in claim reconciliation and payment posting, ensuring financial accuracy in claims processing.
Senior Executive
MDI Healthcare Pvt Ltd.
06.2016 - 04.2020
- Managed healthcare operational processes and documentation, ensuring compliance and accuracy in all areas.
- Coordinated with teams to optimise workflow, contributing to high service quality standards.
- Supported timely processing and accuracy of billing and backend operational activities.
Education
Bachelor of Science - Pharmacy
University of Pune
Pune 04.2001 -
Bachelor of Science - Pharmacy
MSBTE
Maharashtra 04.2001 -
Skills
- Payment posting quality assurance
- Payment reconciliation
- Claims reconciliation
- Payment processing
- Revenue cycle reporting
- Charge entry
- Remittance processing
- Payer portal navigation
- Denial management
- Insurance follow-up
- EOB interpretation
- EOB analysis
- HIPAA compliance
Timeline
Quality Assurance – Payment Posting
TruBridge Healthcare Solutions Pvt. Ltd.
10.2024 - Current
Senior Associates – Payment Posting
TruBridge Healthcare Solutions Pvt. Ltd.
09.2021 - 10.2024
Claim associates
3Gen consulting service LLP
08.2020 - 09.2021
Senior Executive
MDI Healthcare Pvt Ltd.
06.2016 - 04.2020
Bachelor of Science - Pharmacy
University of Pune
04.2001 -
Bachelor of Science - Pharmacy
MSBTE
04.2001 -
CUSTOM
I hereby declare that the information provided above is true and correct to the best of my knowledge and belief.
Place :Pune
Date:
Abhijeet Bhame