GANGA SAGAR
Dundigal
Summary
RCM Team Leader with 10+ years of experience in US Healthcare Revenue Cycle Management, specializing in Accounts Receivable (AR), Denials Management, Claim Follow-up, Appeals, and Revenue Recovery. Proven expertise in managing teams of up to 20 members, driving KPI improvements, reducing AR aging, improving denial resolution rates, and ensuring SLA compliance. Strong experience working with Federal and Non-Federal payers, handling escalations, preparing MIS reports, conducting root cause analysis, and implementing process improvement initiatives. Skilled in stakeholder coordination with coding, eligibility, billing, and quality teams to maximize collections and improve operational efficiency.
Overview
5
5
years of professional experience
4
4
Certifications
Work History
Process Associate-Senior Quality Analyst
Hinduja Global Solutions (HGS)
Hyderabad
09.2020 - 12.2025
- Started as an RCM Associate handling AR follow-up, claim status checks, and denial resolution for US healthcare claims, ensuring timely reimbursement.
- Performed detailed claim investigation using payer portals, EOB/ERA analysis, and claim notes to identify denial reasons and drive faster resolution.
- Managed claim resubmissions, documentation updates, and follow-up actions, ensuring adherence to payer guidelines and client SOPs.
- Promoted to QA Analyst role based on consistent performance, strong process knowledge, and high accuracy in AR/Denials operations.
- Conducted daily/weekly quality audits on AR and Denial transactions, ensuring compliance with HIPAA standards and client quality benchmarks.
- Prepared and published QA scorecards and trend reports, highlighting defect patterns, compliance gaps, and process improvement opportunities.
- Performed Root Cause Analysis (RCA) on recurring defects and implemented corrective/preventive action tracking (CAPA), reducing rework and repeat errors.
- Conducted calibration sessions and structured coaching feedback, improving documentation quality, audit alignment, and overall process accuracy.
Team Leader
VeeHealthTek Pvt Ltd
Hyderabad
08.2024 - 08.2025
- Led a team of 18 members managing end-to-end Accounts Receivable (AR) Follow-up and Denials Management for US Healthcare clients, ensuring SLA adherence and maximum revenue recovery.
- Reviewed and analyzed daily/weekly/monthly performance reports (MIS) for AR and Denials teams, ensuring targets were met for productivity, quality, and turnaround time (TAT).
- Monitored and improved key operational KPIs such as AR Days, Denial Rate, Recovery Rate, Collections %, Clean Claim Rate, and Billing Accuracy through structured action plans.
- Conducted Denial Root Cause Analysis (RCA) to identify recurring denial trends (eligibility, authorization, medical necessity, timely filing, coding-related issues) and implemented preventive measures to reduce revenue leakage.
- Managed AR work queues effectively by prioritizing high-dollar claims, aged AR (90+ days), underpaid claims, and timely filing risk accounts, improving cash flow and reducing backlog.
- Handled complex escalations, payer disputes, and critical aging accounts by coordinating with payers and internal stakeholders to ensure quick resolution and claim closure.
- Coordinated with cross-functional teams including Coding, Billing, Eligibility, Provider Support, Quality, and Analytics to resolve claim discrepancies and operational bottlenecks.
- Conducted regular team huddles, performance feedback sessions, coaching, and refresher trainings, improving team capability and ensuring consistent delivery.
- Ensured strict adherence to HIPAA guidelines, client requirements, internal SOPs, and compliance standards, maintaining high service quality and audit readiness.
- Prepared and shared weekly/monthly dashboards and trend reports highlighting denial patterns, AR aging movement, collection performance, and corrective action progress.
- Performed quality audits and case reviews to minimize rework, improve documentation accuracy, and ensure correct claim handling practices.
- Supported process improvement initiatives by identifying workflow inefficiencies and implementing standard operating templates for follow-up documentation and denial resolution.
Team leader
AGS Health
Hyderabad
05.2022 - 07.2024
- Managed day-to-day operations for AR Follow-up and Denials Management, ensuring consistent delivery against client-defined SLAs and business targets.
- Supervised end-to-end AR functions including claim status review, denial resolution, underpayment analysis, appeal follow-ups, and payer correspondence.
- Acted as primary point of contact for operational updates, supporting management in client governance calls, performance presentations, and action plan reviews.
- Conducted weekly performance calibration sessions to review associate-level output and ensure alignment with productivity and quality expectations.
- Designed and implemented AR prioritization strategies for high-value claims, claim aging, and payer-specific backlogs to maximize reimbursement.
- Worked on payer-specific denial trend analysis and supported development of standardized resolution playbooks for faster turnaround.
- Ensured accurate documentation and adherence to client SOPs, HIPAA compliance, and internal audit requirements, maintaining process discipline.
- Performed random sampling audits and quality checks, ensuring reduction in error rate and improved first-pass resolution.
- Coordinated with internal stakeholders such as coding, charge entry, payment posting, and authorization teams to resolve claim discrepancies and missing information.
- Supported new process transitions by creating SOP documents, training modules, and knowledge transfer materials for smooth onboarding.
- Handled escalations and supported dispute resolution for complex AR accounts, ensuring timely claim closure and minimizing write-offs.
- Developed and maintained daily trackers and AR aging reports, providing insights on denial movement, appeal outcomes, and backlog progress.
Process Specialist/Subject Matter Expert
Cognizant Technology Solutions
Hyderabad
12.2020 - 05.2022
- Acted as Subject Matter Expert (SME) for US Healthcare AR Follow-up and Denials Management, supporting day-to-day process delivery and SLA achievement.
- Handled complex and escalated AR cases including high-dollar claims, aged AR, underpayments, and payer disputes to ensure timely resolution.
- Provided functional guidance to associates on denial categories such as eligibility, authorization, medical necessity, timely filing, COB, and coding-related denials.
- Conducted quality audits and error analysis, identifying recurring issues and sharing corrective actions to improve first-pass resolution.
- Supported Team Leads in monitoring daily productivity, backlog movement, and work allocation to ensure operational stability.
- Created and updated process documentation, SOPs, and knowledge base articles, ensuring standardization across the team.
- Delivered new joiner training and refresher sessions, improving team performance, accuracy, and adherence to payer guidelines.
- Coordinated with internal teams such as billing, coding, eligibility, and payment posting to resolve claim discrepancies and documentation gaps.
Education
MBA - Human Resources Management
Malla Reddy College of Engineering
Hyderabad08-2015
Bachelor of Commerce - Computers
Bhavans Vivekananda Degree College
Hyderabad06-2013
Skills
- Strong communication & presentation skills
- Decision-making and problem-solving ability
- Time management & multitasking
- Conflict resolution & stakeholder handling
- Client relationship management
- Training & onboarding new joiners
- Process documentation (SOP, KT, checklists)
- Data analysis and trend reporting
- Workload allocation & shift management
- Adaptability to changing payer/client requirements
Certification
Certified revenue cycle representative-HFMA
Timeline
Team Leader
VeeHealthTek Pvt Ltd
08.2024 - 08.2025
Team leader
AGS Health
05.2022 - 07.2024
Process Specialist/Subject Matter Expert
Cognizant Technology Solutions
12.2020 - 05.2022
Process Associate-Senior Quality Analyst
Hinduja Global Solutions (HGS)
09.2020 - 12.2025
MBA - Human Resources Management
Malla Reddy College of Engineering
Bachelor of Commerce - Computers
Bhavans Vivekananda Degree College