AMAR KUMAR
Delhi
Summary
Senior Analyst supporting US healthcare claims, accounts receivable, and denial resolution for reimbursement recovery, monitoring $250K+ in AR. Reviews unpaid and underpaid claims, coordinates payer follow-up, and resubmits corrected claims and appeals using payer rules and compliance procedures. Strengthens account resolution through documentation discipline, root-cause analysis, and reporting in Excel and Power BI.
Overview
5
5
Certifications
9
9
years of professional experience
Work History
Senior Analyst
R1RCM
02.2025 - Current
- Resolve 40% of denied claims through payer outreach, corrected resubmissions, and appeals support.
- Contact payers by phone, email, and payer portals to investigate denied, delayed, and unpaid claims.
- Analyze claim status, denial reasons, and account history to determine next actions and escalation paths.
- Maintain accurate account documentation and follow client, payer, and HIPAA compliance procedures.
- Resubmit corrected claims and initiate appeals for denied or underpaid accounts based on payer requirements.
- Support process improvement by identifying recurring denial patterns and strengthening follow-up workflows.
HC Operations Associate
NTT DATA
06.2023 - 12.2025
- Resolved 350 denied claims per week through structured follow-up and payer communication.
- Managed healthcare claims billing and denial-resolution activities for U.S.-based clients across revenue cycle management workflows.
- Conducted AR follow-up and investigated claim rejections to identify root causes and support balance resolution.
- Reviewed payer responses, claim details, and billing records to determine corrective actions and next steps.
- Identified recurring denial patterns and operational issues to support process-improvement efforts.
- Collaborated with team members to maintain quality, productivity, and timely claim resolution.
Appeals Representative
OPTUM
02.2022 - 03.2023
- Analyze disputed claim details to identify resolution paths and guide appeals documentation.
- Escalate potential fraudulent or suspicious claim activity through established client procedures.
- Track denial patterns and surface trends for continuous-improvement reviews.
- Maintain clear case documentation while following client procedures, quality standards, and HIPAA compliance requirements.
- Support claims resubmission and accounts receivable follow-up to move unresolved cases toward closure.
Intern
NBPDCL
06.2018 - 07.2018
- Coordinated schedules and day-to-day administrative tasks to keep project activities organized.
- Summarized findings into clear presentation materials for meetings and decision support.
- Tracked action items and followed up on administrative requests to support timely completion.
Intern
BSPHCL
07.2017 - 08.2017
- Supported daily operations by organizing documents, updating logs, and handling routine administrative follow-up.
- Assisted team members with project tasks, coordination, and basic reporting across assigned workstreams.
- Prepared and reviewed routine records to support process accuracy and timely completion of office work.
Education
Master of Business Administration - Finance
NMIMS
01-2027
Bachelor of Business Administration - Business Management
Magadh University
10-2018
Skills
Revenue cycle management
Denial management
Accounts receivable follow-up
Claims resubmission
Payer communication
HIPAA compliance
Appeals & reconsiderations
Claim rejection & resolution
Root cause analysis
Process improvement
Payer portals
Certification
Google Project Management Certificate
Timeline
Senior Analyst
R1RCM
02.2025 - Current
HC Operations Associate
NTT DATA
06.2023 - 12.2025
Appeals Representative
OPTUM
02.2022 - 03.2023
Intern
NBPDCL
06.2018 - 07.2018
Intern
BSPHCL
07.2017 - 08.2017
Bachelor of Business Administration - Business Management
Magadh University
Master of Business Administration - Finance
NMIMS