Vinay Kumar Komirisetty
US Healthcare
Summary
Experienced in managing billing software such as Centricity, eCW, Care tracker, GMED, Tebra (Kareo), AdvancedMD, and Aethna. Adept in utilizing various billing software to streamline and optimize the billing process, ensuring accuracy and efficiency. Reliable business professional with experience in project management, process improvement and financial analysis. Proven track record of successfully streamlining business operations and reducing costs. Adept at analyzing data to identify trends and developing strategies to improve efficiency.
Overview
8
8
years of professional experience
6
6
Certifications
38
38
years of post-secondary education
3
3
Languages
Work History
Team Lead Operations
Unislink
5 2018 - 2 2021
- Etracting the aging report and segregating the work order to team to clear the 120+ aging
- Aim to clear the high doller claims to mitigate the risk on priority basis
- Adding to people management activities, will work on production to have a control on quality check and guide the team wherever necessary
- Creating Appels for procedures, TFL, Inclusive etc
- Pariticate on weekly and monthly calls with Offshore and Onshore management on updates
- Maintain a inter-personal communication with team to reduce the gaps
- Maintaing the cross trainings within team to grow their learning skills and easy for the team to avail leaves
- Responsible for billing utilizing eCW, Centricity, Care Tracker and Gmed software management system.
Team Leader Operations
Medfin India
11.2016 - 01.2018
- Responsible for billing utilizing HealthFusion and Connect software management system
- Genrating AR aging reports
- Formulating strategies to reduce the DSO and increase the GCR of the process
- Handling a team of 10 associates looking after their productivity as well as quality of delivery of work as well as TAT of client
- Identifying bottom performers and checking their training needs for performance improvement
- Maintaining team attendance, production and quality reports on daily/Monthly basis
- Maintaining Escalation Trackers (Downtime, Insurance and patient)
- Preparing Monthly Decks
- Producing good and effective process plan, which will meet both qualitative and quantitative need
- Co-ordinate with the management for the better growth and prospect of the team
- Managing the team so that there is a smooth and quality movement of the given work
- Handling different queries and answering them so that there is no knowledge gap among the team members
- Experienced with vLookups and data sorting and filtering
- Extensive Excel and pivot table development experience
- Strong skills in maintaining accurate Excel spreadsheets.
Team leader in Operations
Inventurus Knowledge Solutions PVT.LTD
04.2015 - 02.2016
- Handling a team of 8 associates looking after their productivity as well as quality of delivery of work as well as TAT of client
- Producing good and effective process plan, which will meet both qualitative and quantitative need
- Co-ordinate with the management for the better growth and prospect of the team
- Managing the team so that there is a smooth and quality movement of the given work
- Handling different queries and answering them so that there is no knowledge gap among the team members
- Responsible for Medicaid billing utilizing NextGen software management system
- Experienced with vLookups and data sorting and filtering
- Extensive Excel and pivot table development experience
- Strong skills in maintaining accurate Excel spreadsheets.
Senior Executive
Capricorn Systems Global Solutions
01.2014 - 03.2015
- Worked on No Activity (Claim Status) by calling Insurance companies in US
- Worked on Denial claims
- Monthly processing of Patient statements
- Answer and resolve patient billing inquires
- Worked on Gateway rejections to know why a claim was denied, posting and balancing adjustments in software
- Responsible for Medicaid billing utilizing AdvancedMD, Sequel, Ram soft(EHR) and Care Cloud software management system
- Handling the denials & taking action to convert the denial into payment
- Working End to End process in Healthcare for Radiology Services for Guam Island (USA)
- Appeals the claims with primary Eobs to secondary carrier
- Appeals the claims with Medical records
- Responsible for Federal payers like Triwest, Tricare, Tricare overseas, Tricare international, CHAMPVA and VA.
Sr. AR Process Associate
Advanced Interventional Pain Clinic
11.2012 - 12.2013
- Sending authorization request to PCP's and insurance carriers
- Followup with PCP's and insurance carriers regarding for the authorization whether it is approved or denied and requesting them to send copie of authorization approval
- Working on Worked on No Activity (Claim Status) by calling Insurance companies in US
- Working on eligibilities of autos (PIP-Personal Injured Protection)
- Working on denial PIP's (LOP), Workers compensation
- Responsible for Medicaid billing utilizing OmniMD software management system.
AR Process Associate
GSS America InfoTech Pvt
12.2011 - 11.2012
- Worked on No Activity (Claim Status) by calling Insurance companies in US
- Calling to multiple states on denial claims
- Worked on Denial claims
- Worked on Gateway rejections to know why a claim was denied, posting and balancing adjustments in NextGen
- Responsible for Medicaid billing utilizing NextGen software management system.
Process Associate
Nspire Synergy solutions
10.2009 - 10.2011
- Worked on No Activity (Claim Status) by calling Insurance companies in US
- Responsible for handling the billing claims and resolving the denied claims
- Followed up on submitted claims
- Monitored unpaid claims, initiate tracers
- Resubmitted claims as necessary
- Responsible for resolving patient's issues
- Responsible for Medicaid billing utilizing Lytec software management system
- Sending daily and weekly Production reports.
Education
B.Com( Commerce ) -
Allahabad University
Skills
Good Knowledge In MS-Excel (Pivots & Lookup) And MS-Word
undefinedTimeline
Team Leader Operations
Medfin India
11.2016 - 01.2018
Team leader in Operations
Inventurus Knowledge Solutions PVT.LTD
04.2015 - 02.2016
Senior Executive
Capricorn Systems Global Solutions
01.2014 - 03.2015
Sr. AR Process Associate
Advanced Interventional Pain Clinic
11.2012 - 12.2013
AR Process Associate
GSS America InfoTech Pvt
12.2011 - 11.2012
Process Associate
Nspire Synergy solutions
10.2009 - 10.2011
Team Lead Operations
Unislink
5 2018 - 2 2021
B.Com( Commerce ) -
Allahabad University
Personal Information
- Total Experience: 13 Years 0 Month
- Date of Birth: 05/14/84
- Gender: Male
- Marital Status: Married
Personal Information
- Total Experience: 13 Years 0 Month
- Date of Birth: 05/14/84
- Gender: Male
- Marital Status: Married
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