CERNER - Healthcare Billing Software
Kesavan Parthasarathy
Quality Analyst - AR
Summary
Ambitious Quality Analyst with track record of dependability and leadership. Knowledgeable in QA methodology with proven history of reducing errors to increase quality. Proficient in preparing test cases, plans, and scripts. Dedicated to analyzing and resolving defects.
Overview
5
5
years of professional experience
15
15
years of post-secondary education
5
5
Certificates
Work History
Quality analyst
Coronis Ajuba Private Limited
06.2023 - Current
- Managing day to day Quality of the AR Team of close to 80 staff members
- Ensuring delivery of SLAs of cash, ageing and turn-around time
- Ensuring the delivery of KRA of Teams productivity, quality, attrition and Team motivation
- Attending regular conference calls with Clients and responding to their queries timely
- Prepare and present month end reports and analysis on days in AR
- Providing solutions and focus on trend Analysis to resolve pending AR for the end Client
- Develop and maintain a solid working knowledge on products, services and processes performed by the team
- Determine staffing requirements based on volume of AR and provide strategies to build a robust framework in handling day to day activities
- Frequent monitoring and review of days in AR to ensure the volume is sustainable, also provide immediate resolutions when we incur a sudden spike in AR volume
- Weekly meeting with Leaders to ensure our focus and goal is maintained at Client and Customer satisfaction
- Complete focus on rectifying any deviations in the process and providing permanent solutions to alleviate any impact in the process flow
- Weekly & monthly operational review with the Client to provide enhancements that will allow us to meet all the expectations from the End Client
- Mentor new Leaders and staff in handling their respective roles and constant monitoring to ensure their assigned task in operations are carried out diligently
- Maintain project manuals, instructions and Client notices for the team to use as a reference guide and for training purposes
- Periodic review of performance trend and other metrics to measure the productivity and quality in the team
- Weekly review with the AR specialist /analyst to identify trends in claims denials and rejections, and coordinate with internal departments in addressing the issue
- Monitor frequency of denials / rejections from a specific carrier and state
- Ensuring provider enrollments with insurance carriers are completed timely and providing periodic updates to ensure no revenue loss is incurred
- Monitor insurance enrollments in setting up electronic claim submission and electronic remittance advice
- Provide thought processes and idea for automation which had alleviated manual work to avoid any human error
- Ensuring regular follow up is completed with the insurance carrier to follow up on claims statuses, missing payments, denials and rejections
- Work with insurance carriers on underpayments of claims to ensure the claims are re-processed correctly per the contracted rates for each procedure
- Work along with collection agencies to report patient and insurance payments that are made to us, after the AR/patient accounts have been transitioned over to the collection agencies
- Monitor and ensure PHI is maintained and periodic call monitoring and one on one review with staff are carried out by the respective Leads
- Periodic review of performance trend and other metrics to measure the productivity and quality for both teams.
Quality Analyst
Guidehouse India Private Limited
10.2022 - 05.2023
- Conducted thorough root cause analyses on recurring defects, resulting in the implementation of effective corrective actions.
- Provided detailed reports on quality metrics to senior management, enabling informed decision-making regarding process improvements.
- Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
- Collaborated with cross-functional teams to develop and implement targeted solutions for identified quality issues, ensuring continuous improvement.
Quality Analyst
AGS Health
12.2021 - 07.2022
- Involved in analyzing the claim with the help of
software and effective web tools to get the
collection for US healthcare provider. - Strong knowledge in submitting the clean claim and get
paid without multiple touch. - Strong knowledge in handling software's and processflow
- Responsible to maintain the daily allocation and
process updates without any deviation. - Worked on the development of dashboard reports for
the Key. Worked in multiple clearing houses and software's. Generated different types of Line Charts, Bar Charts, and Pie Charts under different quality strategies. - Worked on Root cause analysis (RCA) and its plan of
action (POA). Requirements gathering and built the customized
dashboards both internally and externally. - Involved in sunrise & sunset meetings for arresting the
repeated error's to meet the client expectation. - Involved in client calls for the updates process flow and
timely delivery also, involved in trend analysis for the
quality betterment.
Senior AR Caller
GLOBAL HEALTH BILLING PARTNERS
06.2019 - 11.2020
- Analyzed complex claim issues and collaborated with cross-functional teams to resolve disputes efficiently.
- Developed strong relationships with insurance providers, resulting in faster claims resolution and increased payment rates.
- Streamlined the AR calling process by creating a prioritized list of high-value accounts to focus on for maximum revenue impact.
- Trained new AR callers, sharing best practices and fostering a collaborative team environment for continuous improvement.
Education
Master of Business Administration -
NIBM
Bangalore, Karnataka 09.2022 - 05.2023
Bachelor's in Applied Computer Apps - undefined
National Virtual University
Bangalore, Karnataka 06.2018 - 05.2021
Higher Secondary - undefined
MCC Boys Hr Sec School
Chennai, Tamil Nadu 06.2009 - 05.2011
High School - undefined
TMS Matric School
Chennai, Tamil Nadu 06.1999 - 05.2009
Skills
MS office
Certification
Certified Revenue Cycle Professional, 05/01/2023, 08/01/2023
Accomplishments
- Awarded - Best Performer Award - 2020
- Awarded - Best Quality shout out - 2021
Software
KAREO- Healthcare Billing Software
EPIC - Healthcare Billing Software
MEDITECH- Healthcare Billing Software
Languages
English
Upper intermediate (B2)
Timeline
Quality analyst
Coronis Ajuba Private Limited
06.2023 - Current
Quality Analyst
Guidehouse India Private Limited
10.2022 - 05.2023
Master of Business Administration -
NIBM
09.2022 - 05.2023
Quality Analyst
AGS Health
12.2021 - 07.2022
Senior AR Caller
GLOBAL HEALTH BILLING PARTNERS
06.2019 - 11.2020
Bachelor's in Applied Computer Apps - undefined
National Virtual University
06.2018 - 05.2021
Higher Secondary - undefined
MCC Boys Hr Sec School
06.2009 - 05.2011
High School - undefined
TMS Matric School
06.1999 - 05.2009
Certified Revenue Cycle Professional, 05/01/2023, 08/01/2023
Six Sigma - Master Black Belt
Quality based tool for business development
Certified Business Tools, 11/01/2023, 01/01/2024
Power BI for business development - Data analyst
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