K. Raja Kumar
Summary
Collective experience in Customer service & Process supervision, training & Quality Analyzing, and Co-coordinating the Team & client, in various US healthcare Operations. A proven track record of significant improvements in learning processes, productivity, quality, and customer satisfaction and maintaining a positive work environment, Dynamic decision-maker. Established, maintained, and optimized an effective quality management system.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Service Delivery Manager RCM
Medico Health care
12.2023 - 08.2024
- Company Overview: Health care BPO
- End-to-End RCM - Service Delivery In charge
- Performance Management Productivity, Quality, Client Coordination
- Health care BPO
Operation Manager RCM
ACP Billing Services
09.2022 - 09.2023
- Company Overview: Health Care BPO.
- Successfully implemented two new projects and tracked project implementation.
- End-to-End RCM: Performance Management, Productivity, Quality, Client Coordination.
- Identify, develop, and execute key processes that improve overall organizational efficiency and effectiveness, including governance.
- Facilitate the planning and organization of all strategic initiatives.
- Perform management responsibilities involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management, and staff productivity.
- Health care BPO
Assistant Manager RCM
Rapid Care Solutions
07.2021 - 07.2022
- Company Overview: Health care BPO
- In charge of Daily Deliverables Data and AR (Charge, Payment, EV) and led the team to efficiently deliver client expectations and manage day-to-day activities with the team
- Preparing, projects reviews, transition & migration plans, and project feasibility reports
- Co-ordination and organize training for new joiners as well as for existing members of the team based on the project’s requirements
- Conduct regular conference calls with clients and identify ways to improve client satisfaction
- Identify training gaps in the team and develop a plan with the department
- Health care BPO
Team Leader - Client Services
4D Global Medical Billing Services
06.2019 - 07.2021
- Company Overview: Health care BPO
- Appointed team lead transition and successfully onboarded and led the operation for a two-million-dollar collection project
- Work closely with the operations team to ensure appropriate follow-up is done and identify customer needs that are met with prompt activities
- Sharing Process performance analysis Improvement plan to teams FTE Utilization Tracking & Appraisal performance measuring Handling Training and quality team
- Health care BPO
Sr Team Leader RCM
QBSS Solutions
11.2016 - 05.2019
- Company Overview: Health care BPO
- Transition Management and process Guidance, Client Coordination
- Work closely with the Transition and Operations Team to ensure appropriate follow-up of identifying customer needs and follow-up activities
- Taking care of AR Follow-up & Denial management
- And Demo, Charge Entry, Claim transmission & Clearing house rejection, payment posting
- Introduce Six Sigma methodologies and brought tremendous improvement in the process
- Health care BPO
Sr, Quality Analyst
Apollo Health Street
03.2011 - 12.2014
- Company Overview: IT & ITS Services & Healthcare BPO
- Team Quality Improvement by Identify Quality Improvement needs Work in close coordination with all managers in Transaction processing and Accounts receivables projects to facilitate customized Quality training for each of the teams
- Responsible for Process level Auditing & findings & Denial trend Analysis through Six Sigma methodologies
- Quality Responsibilities in Details: Handling Internal QA Auditing team, Design the Sampling Strategy for the process Monitor process quality check audits, Ensure that Frequency and Event based feedback for the team is complete
- Preparation of Quality Standard Documentation for the process and update it on a regular basis with regards to any changes
- Assist the Operations team in the customer compliant & resolution process for the teams Complete the regular performance review with the team of QAs
- Identify Training needs for the process and Quality team Dash Board Presentation on a Monthly basis
- Achievements: Within very short span TAT, work against the task given by client &Achieved 100 percent Quality and Received Client Appreciation letter with Gift (American Digital Clock)
- IT & ITS Services & Healthcare BPO
Executive Accounts Receivable
Dell Systems (Perot Systems)
04.2008 - 02.2011
- Company Overview: IT & ITS Services & Healthcare BPO
- Responsible for Account Receivable from us health care system Responsible for Day by Day work flow and production
- IT & ITS Services & Healthcare BPO
Process Supervisor
Alind
01.2001 - 06.2006
- Company Overview: Interior decoration
- Responsible for Material Management and Labor Management, Marketing, and Site Supervising
- Calculate the manpower and material, based on the work order
- Interior decoration
Education
MBA - Management Information System & Project Management
National Institute of Business Management
IndiaBA - English Literature
Madras University
Skills
- Communication
- Adaptability
- Problem-solving
- Teamwork
- Creativity
- Leadership
- Interpersonal skills
- Work ethic
- Attention to detail
Certification
- SIX SIGMA GREEN BELT, MSME Chennai, 2010
- Diploma in Quality Auditing ISO 9001 - 2008, MSME Chennai, 2010
Personal Information
- Number of Children: 2
- Marital Status: Married
Timeline
Service Delivery Manager RCM
Medico Health care
12.2023 - 08.2024
Operation Manager RCM
ACP Billing Services
09.2022 - 09.2023
Assistant Manager RCM
Rapid Care Solutions
07.2021 - 07.2022
Team Leader - Client Services
4D Global Medical Billing Services
06.2019 - 07.2021
Sr Team Leader RCM
QBSS Solutions
11.2016 - 05.2019
Sr, Quality Analyst
Apollo Health Street
03.2011 - 12.2014
Executive Accounts Receivable
Dell Systems (Perot Systems)
04.2008 - 02.2011
Process Supervisor
Alind
01.2001 - 06.2006
MBA - Management Information System & Project Management
National Institute of Business Management
BA - English Literature
Madras University
Similar Profiles
Pamula Kranthi KumarPamula Kranthi Kumar
Senior Associate at Medico Health care services and technologiesSenior Associate at Medico Health care services and technologies
Lakshmi Prasanna NallagatlaLakshmi Prasanna Nallagatla
Medical Coder at Medico Health care servicesMedical Coder at Medico Health care services
Paola JuarezPaola Juarez
Hospital Administrator at Centro Medico JuareazHospital Administrator at Centro Medico Juareaz