Hemanth c
Bengaluru,Karnataka
Summary
Results-driven Healthcare Professional with extensive experience in US Healthcare domain. Delivered impactful contributions through effective account receivable management for Medicare, Medicaid, and commercial lines, ensuring compliance with HIPAA regulations. Focused on identifying trends, conducting internal training, and enhancing quality through thorough analysis and self-auditing.
Overview
7
7
years of professional experience
Work History
Revenue Cycle Management Specialist
Red Road Healthcare Solutions Pvt Ltd
01.2021 - 01.2026
- Responsible for following up on all outstanding insured accounts and documenting accounts accordingly in billing application. Assist with tracking insurance payer trends, perform appeals timely and support and adhere to Billing Policy with the use of US Healthcare knowledge
- Reviewing and appealing unpaid and denied claims and providing resolution
- Collaborated with team to resolve claims, facilitating timely payments.
- Good understanding of Denial Management
- Strong working knowledge of managed care plans, insurance carriers
- Researched and audited patient accounts to identify further payment opportunities or necessary adjustments.
- Contributed to team efforts, streamlining resolution process for multiple claims.
- Participated in client calls to gather requirements and implement necessary actions.
- Mentoring and training up junior and new staff.
- Maintained strict confidentiality and adhered to all HIPAA guidelines and regulations.
Assistant client partner
Access Healthcare Pvt Ltd
01.2019 - 01.2021
- Tracked outstanding insured accounts and recorded necessary documentation in the billing application. Monitored insurance payer trends and executed appeals according to Billing Policy.
- Reviewing and appealing unpaid and denied claims and providing resolution.
- Investigated and analyzed patient accounts to ensure accurate billing and facilitate additional payments.
- Supported the team in effectively addressing bulk claims to enhance resolution efficiency.
- Researched and audited patient accounts to identify opportunities for further payments or adjustments.
- Supported the team in resolving claims that led to payment.
- Supported the team in finalizing bulk claims to expedite payment.
- Total Duration Experience of: 2.2 Years
Education
Bachelor's degree - Mechanical Engineering
PUC -
AKT higher secondary school
SSLC -
SKY School
Skills
- Claims Management
- Process improvement
- Strong Analytical abilities
- Microsoft Technologies: MS Office, MS PowerPoint, MS Excel
- Operating System: Windows 7,8,10
- Team collaboration
- Adaptability to change
Declaration:
I Hemanth do here by declare that what is stated above is true to the best of my knowledge belief.
Timeline
Revenue Cycle Management Specialist
Red Road Healthcare Solutions Pvt Ltd
01.2021 - 01.2026
Assistant client partner
Access Healthcare Pvt Ltd
01.2019 - 01.2021
Bachelor's degree - Mechanical Engineering
PUC -
AKT higher secondary school
SSLC -
SKY School