Abhilash Paharia

• - Lead and inspire a high-performing team to achieve and surpass production, quality, and performance targets
  - Take ownership of managing client escalations and ensuring timely and effective resolution
  - Represent the organization in weekly client calls, serving as a key liaison between clients and the organization
  - Provide comprehensive training to newly onboarded associates on PMS/Product functionalities
  - Handle ticket management for new associates' PMS and payor portal access
  - Prepare daily production consolidation, weekly payor-wise aging reports, and various performance trackers
  - Analyze data to identify trends, root causes, and opportunities for improvement
  - Update client issue tracker, missing payment tracker, and credentialing issue log for enhanced operational efficiency

1. Leadership:
- Guided a high-performing Physician AR team in US healthcare revenue cycle management, ensuring excellence in team production, quality, shrinkage, and attrition.

2. Client Management:
- Managed client escalations effectively and represented the organization in weekly client calls, fostering strong relationships and delivering strategic insights for business growth.

3. Training and Development:
- Designed and delivered training programs for new associates on PMS/Product, facilitating smooth onboarding and continuous learning for team members.

4. Access Provisioning:
- Oversaw the access provisioning process for new associates, including raising tickets for PMS and payor portal access, enhancing operational efficiency and productivity.

5. Reporting and Analysis:
- Generated daily production consolidation reports, weekly payor-wise aging reports, and analyzed trends for discussion in client calls, driving data-driven decision-making and performance improvement.

6. Performance Monitoring:
- Managed MTD and WTD trackers to monitor key performance metrics, enabling proactive interventions and continuous improvement efforts to achieve organizational goals.

7. Issue Resolution:
- Conducted monthly root cause analysis and updated client issue tracker, missing payment tracker, and credentialing issue log, demonstrating a commitment to excellence and client satisfaction through effective problem-solving strategies.

- Successfully onboarded and transitioned new client, ensuring alignment with their goals and objectives.
- Managed high-dollar claims and reduced volume, improving efficiency.
- Prepared daily production consolidation, ensuring accurate reporting of key performance metrics.
- Led appeals process, resolving claim disputes to maximize revenue and client satisfaction.
- Prepared comprehensive inventory reports, analyzing trends and identifying areas for improvement.
- Proactively reported new trends and issues, facilitating prompt decision-making and problem resolution.
- Mentored and trained team members, fostering a culture of continuous learning and development.

- Processed and posted payments, adjustments, and denials accurately and in a timely manner.
- Followed up with insurance companies to ensure timely reimbursement.
- Collaborated with other departments to resolve complex payment issues and reduce accounts receivable.
- Assisted in the preparation of reports on payment posting and claim status.

- Processed and posted payments, adjustments, and denials accurately and in a timely manner.
- Followed up with insurance companies to ensure timely reimbursement.
- Collaborated with other departments to resolve complex payment issues and reduce accounts receivable.
- Assisted in the preparation of reports on payment posting and claim status.

- Conducted insurance verification and eligibility checks to ensure accurate billing and reimbursement.
- Prepared and submitted claims for various insurance providers.
- Followed up with insurance companies to resolve claim denials, rejections, and underpayments.
- Researched and resolved outstanding accounts receivable issues to maximize revenue.
- Collaborated with internal departments to ensure accurate and timely claims submission.