ANAND RANGARAJ

Executive Leader | Physician & Hospital Billing | Training & Compliance Performance Optimization

Strategic Revenue Cycle executive with extensive experience leading physician and hospital billing operations while integrating financial optimization, enterprise training, and regulatory compliance . Proven ability to improve reimbursement, reduce A/R days and denial rates, strengthen audit readiness, and elevate workforce performance through automation, data analytics, and scalable training programs. Recognized for driving sustainable revenue growth and operational excellence in complex healthcare environments.

Revenue Cycle Operations • Physician & Hospital Billing
Financial Performance Optimization • Compliance & Audit Management
Training & Workforce Development • Denial Prevention & CAPA Programs
A/R Management • Clean Claim Rate Improvement
CMS, HIPAA & Payer Regulations
EHR & Practice Management Systems
Automation & Workflow Standardization
Budgeting, Forecasting & Financial Analytics
Change Management • Cross-Functional Leadership
KPI Dashboards & Performance Reporting

• Led end-to-end revenue cycle operations across physician and hospital billing, including registration, eligibility, coding, claims, payment posting, denials, appeals, and patient collections
• Delivered financial performance optimization , increasing provider reimbursement from $4M to $5M+ through improved billing accuracy, denial mitigation, and payer strategy alignment
• Reduced A/R days and improved cash flow by standardizing workflows, automating processes, and strengthening payer follow-up protocols
• Improved clean-claim and first-pass resolution rates through coding audits, payer rule validation, and targeted staff education
• Designed and executed CAPA and denial prevention programs , reversing denial trends and improving reimbursement sustainability
• Partnered with IT, Finance, Operations, and Compliance to automate revenue workflows and enhance system integration
• Directed budgeting, forecasting, and revenue analytics , aligning operational execution with enterprise financial goals
• Ensured full compliance performance optimization , maintaining adherence to CMS, HIPAA, payer contracts, and regulatory requirements through audits and controls
• Directed enterprise-wide training strategies supporting revenue cycle operations, compliance, leadership development, and system implementations
• Managed a team of training managers and leads , ensuring consistent, compliant, and high-quality instruction across departments
• Developed customized learning programs to improve billing accuracy, denial prevention, and staff productivity
• Led field, virtual, and hybrid training initiatives for geographically dispersed teams
• Oversaw creation, editing, and approval of:
  SOPs and training manuals
  E-learning content and LMS curricula
  Multimedia and visual instructional materials
• Evaluated training effectiveness using performance metrics, audit results, and operational KPIs
• Optimized training budgets by deploying cost-effective, scalable learning platforms
• Ensured staff readiness for regulatory audits, payer reviews, and system upgrades
• Increased reimbursement collections by $1M+
• Reduced denial rates and strengthened appeal success
• Improved A/R performance and revenue predictability
• Elevated compliance posture and audit readiness
• Strengthened workforce capability through structured training and leadership development

• Proven leader with extensive experience driving strategic performance improvement, client relationship management, and cross-functional collaboration in complex, global environments. Adept at aligning long-term organizational objectives with client goals through the development and execution of comprehensive operational plans in areas such as force management, training, quality, and staffing. Skilled in leading high-performing, diverse teams while fostering an inclusive, collaborative culture.
• Demonstrated ability to identify and implement process improvements using root-cause analysis, and data-driven decision-making. Strong financial and operational acumen, with experience in financial modeling, budgeting, and performance metrics management. Expert in delivering impactful client and internal business presentations, with exceptional interpersonal, communication, and conflict-resolution skills.
• Technologically proficient and experienced in collaborating across departments, including IT, WFM, Client Services, and Change Management. Maintains a deep understanding of HIPAA compliance and consistently ensures top-tier service quality for both internal and external stakeholders. Flexible and committed to supporting 24/7 operational environments with hands-on involvement at all levels of execution
• Formalized standardized reporting frameworks by collaborating across operations, analytics, and client-facing departments, enabling consistent measurement of KPIs and streamlining performance review cycles
• Enhanced customer satisfaction by resolving disputes promptly, maintaining open lines of communication, and ensuring high-quality service delivery.
• Cross-trained existing employees to maximize team agility and performance.
• Managed budgets effectively, ensuring optimal financial performance while investing in necessary resources for business growth.

• A results-driven operations leader with proven expertise in driving efficiency, optimizing processes, and leading high-performing teams. Skilled in strategic planning, daily operations management, and cross-functional coordination to meet business goals. Adept at reducing costs, improving service quality, and implementing scalable systems.

Key Responsibilities:

• Oversee day-to-day operations across departments, ensuring alignment with organizational goals.
• Passionate about learning and committed to continual improvement.
• Skilled at working independently and collaboratively in a team environment.
• Worked well in a team setting, providing support and guidance.
• Self-motivated, with a strong sense of personal responsibility.
• Drive process improvement, cost optimization, and quality assurance initiatives.
• Lead and develop operational teams to enhance productivity and accountability.
• Monitor KPIs such as cost per unit, process cycle time, CSAT/NPS, and compliance.
• Ensure timely delivery, regulatory compliance, and high customer satisfaction.
• Key Achievements:
• Reduced operational costs by 18% through automation and efficiency programs.
• Improved process turnaround by 30%, enhancing service delivery.
• Boosted customer satisfaction with a 23-point increase in NPS.
• Led teams across multiple locations, achieving 95%+ on-time delivery rate
• Implemented digital dashboards, reducing reporting time by 40%.

Core KPIs:

• Operational efficiency, cost reduction, employee productivity, CSAT/NPS, and quality metrics.
• Directed cross-functional teams of 40+ staff across three regions, leveraging Lean Six Sigma methodologies to streamline emergency department revenue cycle workflows, which decreased average account processing time by 25% and increased regulatory compliance audit pass rates to 99% over a 12-month period.

• Review and enter patient charges into the billing system based on medical records and provider documentation.
• Ensure correct CPT, ICD-10, and modifiers are applied for compliant billing.
• Post payments (EOBs, EFTs, checks) accurately to patient accounts in alignment with payer remittance advice.
• Reconcile payment discrepancies, denials, and underpayments; escalate unresolved issues to AR or denial teams.
• Maintain audit trails, verify insurance eligibility, and support month-end closing.
• Collaborate with billing and coding teams to ensure data integrity and revenue accuracy.
• Key Skills:
• Expertise in medical billing systems (e.g., Epic, Kareo, NextGen).
• Strong knowledge of EOBs, ERA files, ANSI 835 formats.
• Understanding of payer-specific guidelines and HIPAA compliance.
• Streamlined payment posting workflow by integrating automated reconciliation processes in Epic, processing over 3,000 EOBs and EFTs monthly, which reduced manual errors by 25% and accelerated month-end close cycles by two days.

• Experienced AR Caller, skilled in handling U.S. healthcare insurance follow-ups to resolve unpaid or denied claims.
• Responsible for contacting insurance companies, verifying coverage, and ensuring timely reimbursements. Proficient in interpreting EOBs, ERAs, managing denials, and documenting call actions accurately.
• Works closely with billing and coding teams to support revenue recovery, while meeting daily productivity and quality standards.
• Recovered over $1.5M in delayed claims within a six-month period by analyzing denial trends, initiating targeted payer outreach, and deploying root cause analysis tools to improve claim resolution rates by 23%.

• Core Responsibilities:
• 1. Medical Billing and Claims Processing
• Enter, verify, and process medical claims and patient information.
• Submit claims to insurance companies and follow up for timely reimbursement.
• Correct errors and resubmit rejected or denied claims
• Management (RCM)
• Handle end-to-end RCM tasks including patient registration, charge entry, payment posting, and AR follow-up.
• Monitor outstanding claims and resolve aging AR (Accounts Receivable).
• 3. Medical Coding Support (if applicable)
• Support in assigning appropriate ICD, CPT, or HCPCS codes based on medical records (for certified coders).
• Ensure coding compliance as per payer and government regulations.
• 4. Patient & Provider Communication
• Handle calls/emails to clarify billing issues or insurance coverage with patients and providers.
• Respond to inquiries and resolve concerns professionally.
• 5. Documentation & Quality Checks
• Maintain accurate and up-to-date records in the system.
• Follow internal QA guidelines to ensure data integrity and compliance.
• 6. Adherence to Compliance and Policies
• Follow HIPAA and other regulatory guidelines.
• Stay updated on healthcare industry standards and payer-specific policies.