Kamaljit Kaur

• Identify and implement strategies to enhance operational revenue within the unit.

• Analyze revenue streams and recommend optimizations to maximize revenue generation.

• Collaborate with relevant stakeholders to streamline revenue-generating processes.

• Oversee case management processes to ensure efficient handling of revenue-related cases.

• Authorization Management: Ensure timely and accurate authorization processes to facilitate revenue capture.

• Claims Management: Oversee claims processing and adjudication to minimize denials and maximize revenue reimbursement.

• Denials Management: Develop and implement strategies to reduce claim denials and facilitate appeals when necessary.

• Accrual Reviews: Conduct regular reviews of revenue accruals to ensure accuracy and compliance with accounting standards.

• Handling the team of billing and Admission desk.
• Monitoring weekly Insurance bill register report and signing off with finance and RCM department.
• Conducting monthly billing audits to ensure that customers under contract were properly invoiced and tracked across all internal systems.
• Addressed customer issues with compassion and professionalism, ensuring swift, successful resolution.
• Upskilled staff through targeted training opportunities, enhancing team capabilities.
• Accepting and approving Guarantee of Payment letters for the concerned companies.
• Approving cost estimates for proposed inpatient/outpatient procedure for corporate clients & Self payers.
• Claims experience of unique services as Organ Transplant, Bone Marrow Transplant, Fetal Surgeries and Oncology services.
• Dealing with Insurance Companies & corporate clients for acquiring special approvals
• Review, verify and update patient financial account information as received to ensure accurate payment for services and prompt notification and follow up with companies and sponsors, coordinate effectively with Case Managers regarding patient financial status and responsibilities
• Maintaining the records of corporate approvals, Bills, contracts, agreements, Cost Estimations, discounts etc
• Conducting meetings with the corporate companies for the unpaid bills.
• Responsible for efficient facility services, consolidate & solve the patient /client's complaints.

• Responsible for management of OP/IP approval process, follow-up and negotiate on difficult approvals
• Monitoring denials, appeals, and resolutions from participating payers and working proactively to collect from insurance companies
• Lead the performance management process that measures and evaluates progress against departmental and unit specific goal
• Provide training on insurance policies and protocols to insurance and front office staffs
• Foster organizational culture by establishing quality awareness and service orientation and complying and implementing processes such as Project Management and Change Management
• Ensure that coding, claims adjudication/processing tasks are performed in a timely, accurate and efficient manner and meet all regulatory requirements
• Evaluate the disallowance reasons; identify the improvement areas and implement the changes
• Review, investigate, and respond to claims appeals and grievances
• Oversee claim adjudication decision-making to ensure alignment of decisions according to set guidelines and processes
• Regularly submit reports to the management on submission of claims, remittance, and re-submission, and insurance receivable ageing
• Ensure that business decisions and processes are documented in a professional way and that communication requirements are being adhered in a timely and professional manner
• Prepare the department for audit process including Insurance audits, Tasneef etc.

• Coordinate all updates, changes and improvements necessary to ensure daily billing processes are running efficiently using IT systems and other resources
• Maintains periodical review claims
• Accomplishes admissions human resource objectives by recruiting, selecting, orienting, training, assigning, scheduling, coaching, counseling, and disciplining employees; communicating job expectations; planning, monitoring, appraising, and reviewing job contributions; planning and reviewing compensation actions; enforcing policies and procedures
• Assist Revenue cycle department in resolving in any objections and rejections from insurance companies
• Preparing, implementing and monitoring corrective measures taken for administrative rejection-based remittance Advise from insurance companies
• Check that all transaction from monthly summary is properly encoded and complete, makes necessary corrections particularly on drug codes and ICD-10 codes
• Accomplishes high bed occupancy by designing, establishing, and maintaining procedures and policies to assure high bed occupancy and control bed availability and patient traffic
• Monitoring Accrual report and escalating not submitted cases to Revenue cycle management
• Monitoring monthly submission of invoices and payment of corporate clients
• Providing financial clearance to accept external patient transfer coming in to the facility
• Preparing report and Initiating meeting with key stakeholder for extended length of stay Inpatient cases to discuss on the discharge plan
• Assists patients with concerns & complaints

• Auditing Invoices to verify the services were provided and charges are accurate
• Document patient data in computer systems
• Responsible for monitoring the discounts in coordination with the billing manager and finance manager
• Responsible for correction of billing errors happening from front desks
• Daily screening of admissions/discharges and Insurance approvals
• Screening and Checking of bills on a daily basis for its accuracy / approvals
• Daily screening of Inpatient census list with the outstanding of self-paying patients and follow-up for payments
• Dealing with corporate clients for approvals
• Answered telephones, handling problematic patients with billing related issues
• Maintains expertise of systems and processes that impact admission, verification, and other patient access related functions
• Applying approvals for community doctors& in-house doctors for inpatient authorization of patients having planned admissions under insurance.