Gopal Kuppan

• Monitor daily Charges and Current Denials and complete on daily basis.
• Daily Payment Reconcile .
• Evaluate team performance and provide feedback as required.
• Work on Weekly & Month End Reports.
• Prepare monthly invoice to specimen suppliers.
• Reviewed billing problems, researched issues, and resolved concerns.
• Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
• Improved medical billing processes by streamlining workflows and implementing efficient systems.
• Monitored compliance with industry regulations to mitigate risks associated with audits and penalties.
• Managed a team of dedicated medical billers, focusing on professional development opportunities and maintaining a positive work environment conducive to high levels of productivity.

• Worked as a “Account Receivable” (Rejection, AR Follow Up, Payments, Insurance Credit, Correspondence, )
• Roles & Responsibilities:
• Focus on daily rejection and complete within TAT.
• Plan daily AR work order start of the day.
• Work on daily correspondence and act accordingly.
• Work on Insurance credits Bi-Weekly and address the refunds.
• Post the 90+ claims payments after cashed info confirmed.
• Medical Billing

• Worked as an 'Assistant Manager – Operation & Transition' (Demo, Charges, Rejections, Payments, Web AR, Denial Management, Statements, AR, Exclusions, Correspondence, Credit Balance) at 'Inniti Alliance,' Pune, Maharashtra.

Roles and Responsibilities:

• Monitor the daily workload across the client and process.
• Monitor workload status through the tool, and assure that daily activity is completed as per TAT.
• Weekly performance review, in terms of productivity and quality.
• Analyze the weekly rejection and denial trends, and provide feedback to the respective team to avoid future errors in order to enhance revenue.
• FTE utilization across the process, head count analysis, and each client.
• Software setup and implementation process for new clients.
• Daily huddle with the team leader to understand the volume and plan of action toward completion.
• Supervised day-to-day operations to meet performance, quality and service expectations.
• Mentored junior staff members in their professional development by offering guidance/support in their assigned roles.

• Worked as a “Assistant Manager” (Payments, Web AR, Statements, AR, Exclusions, Correspondence, Credit Balance) at “Medico Inc”, Telangana, Hyderabad.
• Roles & Responsibilities:
• Direct interaction with client on daily/weekly status.
• Publish weekly and monthly team performance across the process.
• Quality improvement program such as Process Knowledge Test monthly twice.
• Focus on client escalation and figure out root cause for permanent fix.
• Implemented Tracking mechanism to track daily inflow (Across the process) and daily completion.
• Head count analysis by process and project actual requirement by volume.
• Process improvement plans to increase the revenue by resolving AR Global issues.
• Improve clean claim % by providing feedback to Billing & Eligibility team.
• Medical Billing

• Working as a “Sr. Team Lead” (Accounts Receivable, EDI Rejections, Denial Management, Correspondence, Credit Balance) at “Gebbs Healthcare Solutions Pvt Ltd”, Navi Mumbai.
• Roles & Responsibilities:
• Hosting weekly call and provide the status on individual process and explain if there is any challenges.
• Billing invoice by transaction basis for different process separately.
• Present weekly deck slides to client to explain the progress and challenges.
• Evaluate monthly performance for each team member and provide feedback in terms of productivity, quality & attendance.
• Checking emails on daily basis and give first priority to client emails.
• Conduct briefing session daily basis and educate the team on recent updates.
• Medical Billing

• Working as a “Team Lead” (Payment Posting, Working on Reports) at “IKS Health”, Hyderabad.
• Roles & Responsibilities:
• Monitor 15 associate activity and confirm whether they met daily targets.
• Allocate batches and to individual and get it done by EOD without carry forward.
• Knowledge on coding, Modifiers, CCI edits.
• Checking emails on daily basis and give first priority to client emails.
• Taking briefing session daily basis and educate on recent updates.
• Monitoring individual production on daily basis and assist/train them to improve production.
• Compare individual production and quality % on weekly/monthly and publish best performer of the month.
• Working on special project report and allocate the team to complete the task.
• Medical Billing

• Working as a “Sr. Process Lead” (Account Manger, Revenue Cycle Management and handling end to end process Demo, Charge Entry, EDI, Payments, Denials, Appeals, Patient Statements & AR) at “Starmark Software Solutions Pvt. Ltd”, Mysore.
• Roles & Responsibilities:
• Monitor 3 leads activity and confirm whether they met daily activity(Viz Team briefing/Daily Huddle)
• Keep a tab on Demo, Charge entry, payment posting, EDI, denials & statement process completing within TAT.
• Credentialing, EFT & payer Enrollments.
• Allocate post call claims to AR team to call insurance and get the status after pre call action done.
• Monitor AR action take accurately after call.
• Fixing payer level global issues.
• Knowledge on coding, Modifiers, CCI edits.
• Checking emails on daily basis and give first priority to client emails.
• Hosting weekly client call (every Wednesday) for the weekly status and issues.
• Monitoring each process daily deliverable within TAT.
• If any team member is on leave/absent, need to re-allocate the assigned task for smoother process and daily deliverables.
• Focus on Insurance AR and reduce 90+ claims AEAP by getting the payments from insurance.
• Monitoring individual production on daily basis and assist/train them to improve production.
• Update team on client specification and monitor everything is followed as per client requirement.
• Compare individual production and quality % on weekly/monthly and publish best performer of the month.
• Preparing monthly revenue/collection report.
• Medical Billing

• Worked as a “Senior Reimbursement Specialist” (Insurance Rejections (Denials), EDI, Patient & Insurance Credit) at “Pradot Technologies”, Bangalore.
• Roles & Responsibilities:
• Working on EDI rejections. (Gateway, Emdeon, Navicure, Alteer, Zirmed & Allscript)
• Working on Patient and insurance credit monthly basis.
• Take accurate action on 5010 EDI rejections.
• Escalating the Enrollment and Credential issue to Account Managers.
• Audit the fresher's work and provide the feedback.
• Working on the Clearinghouse, EDI &payer rejections.
• Medical Billing

• Worked as a “RCM (Revenue Cycle Management)” (AR Calling & Analysis, Current Denials, Payment Posting, EDI, Charge Validation, Paper Claims & Reports) at “SysInformation Healthcare India Pvt Ltd,”, Kuvempunagar, Mysore.
• Roles & Responsibilities:
• AR Calling
• Posting payments once we receive deposit confirmation from the client.
• Charge validation to avoid rejection & referral denials.
• Sending WC, Referral & Secondary claims by paper.
• Audit the Charge validation & payment posting batches.
• Working on the Clearinghouse, EDI &payer rejections.
• Preparing weekly ops report (Unallocated payment, patient & insurance credit balance, Denial category, Missing Tickets, rejections & AR Categorization.)
• Preparing Monthly Ops Slides.
• Month Closer & reports.
• Medical Billing

• Worked as a “Junior Transaction Executive” (PAYMENT POSTING) at “OMEGA HEALTHCARE MANAGEMENT INDIA PVT. LTD”, HAL Airport Road, Murugeshpalya, Bangalore.
• Roles & Responsibilities:
• Posting the payment batches within TAT.
• Balancing the monthly deposits.
• Audit the batch which is posted by fresher's.
• Resolving the issues raised by client related payment posting.
• Reviewing and escalating the payment related queries and forwarding same to manager.
• Medical Billing