Durga M

Roles & Responsibilities:

• Conducted training sessions on processes and software for new and existing team members.
• Managed end-to-end revenue cycle management operations to maximize efficiency.
• Monitored productivity metrics to ensure compliance with process standards.
• Led a team, supervising performance to achieve operational targets.
• Provided floor support and real-time assistance to enhance team effectiveness.
• Handled work allocation, ensuring proper task distribution within the team.
• Conducted regular quality review meetings, providing feedback for performance improvement.

• Addressed and reduced over 90 accounts receivable denials by identifying trends and resolving in bulk.
• Managed accounts receivable emails and handled related calling inquiries efficiently.
• Trained new employees on billing software and denial resolution processes.

• Resolved billing issues identified by insurance carriers and patients
• Reviewed claim denials and payer requirements for corrective action and prevention in the future.
• Researched and replied in a timely manner to insurance patient.
• Kept accurate records of all activity and conversation for each claim.
• Corrected and resubmitted claims denied by insurance company.
• Coding of inpatient and outpatient procedure from operative reports by using ICD 9 and CPT codes and applying modifiers when needed.
• Received physician's charges via a super bill and submitted electronically to insurance carrier.
• Responsible for all follow up on insurance claims to Medicare Medicaid and commercial insurance.