KR. Sampath
Hyderabad,Telangana
Summary
Experienced Revenue Cycle Management (RCM) Analyst with a strong track record of driving results and improving business processes. Skilled in building strategic partnerships and leading cross-functional teams to achieve organizational goals. Known for leveraging critical thinking and problem-solving skills to foster innovation and drive growth.
Overview
12
12
years of professional experience
Work History
Sr Executive -Service Coordinator
Aeries Technologies Group Private Limited
06.2022 - 03.2024
- Team Handling for the Client On boarding , Prior Authorization and AR follow ups.
- Boosted operational efficiency through implementation of lean principles, resulting in reduced waste and improved production timelines.
- Streamlined operations for increased efficiency by identifying bottlenecks in sales processes and implementing targeted solutions.
- Worked on denial management into Authorization and many based on queue allocation
- Worked with trainers, mentors, and managers on streamlining processes when areas for growth are identified
- Performs administrative tasks related to provider issues
- Filed medical claims made by customer by entering and organizing data and inputting all information into the computer system
- Determine the amount of coverage and sent payments to medical facilities
- Familiarity with ICD-10, HCPCS, CPT coding, CMS 1500
- Adjudicate for deductible provision
- Manage and distribute co-pays, co-insurance maximums and provider settlements
- Provider's first level of assessment of receipts and expenses report in compliance to client's subscription and policies and procedure
- Responsible to validate the provided document as per the client acceptance
- Compare the data with the source document and need to re-enter the data if any incorrect auto capture data
- Responsible to maintain the quality parameters as per the client instructed threshold
- Escalating the high light to the client level if provided source document is incorrect
- Addressing the assigned task within the given timeline and meeting up the Service level Agreement
Senior Claims Associate
Optum Technologies
07.2015 - 06.2022
- Company Overview: Hyderabad
- Proficient in analyzing and resolving denial claims, identifying root causes, and implementing corrective actions to reduce future denials
- Analyzed trends within assigned portfolio to proactively address common issues and improve overall team performance.
- Implemented a streamlined documentation system that simplified record-keeping tasks while increasing accessibility for team members.
- Managed high-priority claims in a time-sensitive manner, resulting in expedited resolution and satisfied clients.
- Experienced in managing and processing claims denials, including reviewing and appealing denied claims to ensure timely reimbursement
- Adept at communicating with insurance companies, and internal teams to address and resolve denial issues efficiently
- Experienced with AR management software and electronic health record (EHR) systems, including tools for tracking and managing denials
- Strong attention to detail in reviewing and processing denial claims, ensuring accuracy and compliance with payer requirements
- Experience working collaboratively with billing, coding, and other departments to address denial issues and streamline the revenue cycle
- Capable of managing multiple denial cases simultaneously while meeting deadlines and maintaining high-quality work standards
- Skilled in training and mentoring junior staff on denial management best practices and procedures
Office Manager
AOF Filtration systems Pvt Ltd
06.2012 - 09.2015
- Company Overview: Hyderabad
- Developed paperless environment by improving online functions
- Organize office operations and procedures
- Scheduling meetings and appointments
- Provide general support to visitors
- Update and maintain office policies and procedures
- Organizing the office layout and ordering stationery and equipment
- Partner with HR to update and maintain office policies as necessary
- Address employee's queries regarding office management issues
- Hyderabad
Education
MBA - HR
12-2013
Bachelor of Science - Bio-Technology
06-2009
Kakatiya University
Skills
- Problem-Solving Skills
- Process Improvement
- Compliance Knowledge
- Team Collaboration
- Operating System
- Application Software's
- Ticketing Tools
- RCM Applications
- Operations management
- Report preparation
- Cross-functional team coordination
- Staff management
Languages
English
Telugu
Hindi
Personal Information
- Father's Name: K. Satyanarayana Reddy
- Date of Birth: 09/16/88
- Nationality: India
Timeline
Sr Executive -Service Coordinator - Aeries Technologies Group Private Limited
06.2022 - 03.2024
Senior Claims Associate - Optum Technologies
07.2015 - 06.2022
Office Manager - AOF Filtration systems Pvt Ltd
06.2012 - 09.2015
Jawaharlal Nehru College - MBA, HR
Priyadarshini Degree College - Bachelor of Science, Bio-Technology
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