Gufran Shaikh

• Managing a team of 31 FTE's engaged across Billing and credit & rebill
• Customer service stakeholder management
• Taking care of all the escalations, reporting of the team data, Weekly decks, MTM reporting of the entire team
• Have done 3 successful transitions for the Billing team (Fire suppression, Fire NJPA & Special, DTB)
• Accountable for Service Delivery on monthly billing of $60+ million across 20,000+ customers spread across local and special customers
• Work along with Stakeholder and Automation teams to simplify current process
• Manage attrition, audits & idea management for entire department
• Connect with Sr
• Manager & Director for business developmental strategy while building relationship with Top leadership in Partner Entities
• Conducted regular team meetings to communicate updates, goals, and expectations for billing capability
• Responsible for credit and rebill (Correction and Modification)
• Responsible to manage workload distribution and ensured adequate coverage for all billing activities within the scope of the SLA/KPI
• KPI management with revenue targets
• Responsible to resolve customer queries related to billing and services
• Supporting Senior Management Team and Departments heads with in-depth analysis
• Responsible for doing RCA and fix the issues

• Responsible for overall billing special accounts in coordination with internal stakeholders
• Consistently achieve a minimum of 95% monthly billing FPY with $60+ million revenue increases (30%)
• Consistently achieving SAL of 98.5% volumes with wait time of 24 hrs
• Dispute Management
• Prepare presentations to the Senior Management Team
• Payment research
• Process Improvement and simplification

• Responsible to take care of credit and rebill along with the modification for the whole team
• Consistently achieving SAL of 98.5% volumes with wait time of 24 hrs
• Dispute Management
• Prepare presentations to the Senior Management Team
• Payment research
• Process Improvement and simplification

Responsible to process L&M invoices based on customer contract.

Responsible to do audits for team members.

• Responsible to checking and verifying the eligibility
• Timely Claim Submission
• Payment Posting
• Denial Management
• Patient Follow-ups
• Assess compliance with claims regulation and controls
• Check various claims documents and files for accuracy and compliance
• Processing QA of all claims on weekly basis