Certified Professional Coder
Lalith Ranjan D
OPERATIONS LEAD - RCM
Bangalore
Summary
Experienced professional with 9.7 years of dedicated focus in RCM services. Demonstrated expertise in healthcare environments, particularly in financial operations and process improvement. Proven ability to analyze and optimize revenue cycles, ensuring compliance and driving efficiency. Seeking a transition into a new field to leverage transferable skills in strategic planning and data analysis.
Overview
10
10
years of professional experience
2015
2015
years of post-secondary education
4
4
Languages
Work History
Operations LEAD
Flatworld Solutions
05.2022 - Current
- Focusing on EPIC Health revenue and customer response answering their concerns and reviewing towards the solution.
- Handling Escalation calls and Emails of customers and insurance companies.
- Handling 22 associates with 4 different LOB’s like Charges, Posting, E&B & AR.
- Connect with Supervisor’s on weekly updates and progress on the revenue.
- Connecting with vendor company where business has been outsourced and checking the Weekly performance.
- Finding out the trends and fixing the issue directly with payor/clearing house.
- Allocating work to the Team and assigning the TAT to complete the task.
- Demonstrated knowledge of company's mission, purpose, goals, and the ability to help employees successfully achieve them
- Focusing on generating revenue by finding out trends and getting the solution to it.
Assistant Operations manager
R1 RCM
08.2020 - 04.2022
- R1 RCM acquired RCM Cerner org from August 2020., in R1 managed the team of 40 with 2 clients’ contracts on the term basis and preparing Analysis on under category clients with reasons, presenting Bi-weekly and Weekly reports to the clients
- Quick turnaround to all customer requests and ensuring that all team members make sound decisions based on customer satisfaction
- Delegating work to the team and explaining importance and deadline of the report’s client basis
- Inventory controls, staffing & hiring associates based on business purpose
- Discussing with clients regarding projects on Bi-weekly calls, to keep a good communication with the clients
- Administering day-to-day operations, controlling absenteeism and attrition in the process defining KRA's of leads
- Identifying problems, providing solutions for process related issues, and updating clients regarding the same
- Working with Cross-Functional Teams to ensure that both internal and external customer needs are met
- Coordinating workflow among various sub process, prioritizing and delegating tasks.
PFS Team Lead
Cerner Healthcare
12.2016 - 08.2020
- Promoted as PFS Team Lead in 2019
- As a Lead my work was interactive towards presenting the reports for Clients and delivering the daily deliverables.
- Handled team of 35+ FTEs (Claim Processing team & Denial Team) and making sure each associate is in TAT with quality. Assisted employee by providing process related solutions.
- Working on reports for the clients and managers’ report bi-weekly.
- Accountable for maintaining the KPI metrics, Team productivity and Quality.
- Adapted all phases of the Medical Billing Cycle (Charges, Payments, AR, Correspondence, Refunds, Coding, Billing, Monthly reports, claims transmission, handling rejections, send daily reports, team handling and respond Client emails)
- Ensured one-on-one sessions with team members for performance appraisal and annual review.
- Promoted as Subject Matter Expert in 2018
- Responsible for leading 20+ people of a team. Duties include making a work plan every day, running reports, creating spread sheets, resolving issues brought forward by team, and ensure the smooth operations of our billing practice.
- Assisting team on their clarifications and used to work on the client deliverables within TAT.
- Attention to detail and organizational skills evident in the preparation of accurate weekly and monthly reports within tight deadlines to team and to client.
- Mentored and guided employees ensuring all were trained in product knowledge and capable of performing assigned duties.
- Demonstrated knowledge of company's mission, purpose, goals, and the ability to help employees successfully achieve them.
- Promoted as Senior Medical Billing Specialist in 2017
- Helped in assisting RCM Manager with process improvements to increase revenue and manage time Effectively prioritize tasks and execute them in a high-pressured environment.
- Creating and implementing a new form of tracking denial trends that saves time and provides a quick and efficient way to monitor them with "live spreadsheets".
- Enforcing management's goal to spot denial trends, documenting them, and find an immediate resolution.
- Valuable experience in Medical Billing regarding AR follow up & Denial Management.
- Running AR reports determining outstanding balances, cash collections, inventory, product usage, and doctor referral.
- Joined Cerner as a contract employee through Adecco starting Dec 2016 to till May 2017 as Medical Billing specialist
- Started a pilot batch with Cerner clients. Working with management, supported project and as a AR specialists worked with team to maximize returns for a specified client with revenue cycle optimization.
- Building strategies that minimize errors and produce clean claim submissions.
- Identifying issues and trends that result in non-payment of claim due to internal/external review, elevating significant issues to the Supervisor.
Analyst
Omega healthcare
08.2015 - 12.2016
- Joined as a fresher soon after training started working directly with the insurance company, healthcare provider, and patient to get a claim processed and paid
- Worked as supportive auditor - inventory control during peak time or as needed and reviewing and appealing unpaid and denied claims
- Proactively following-up on outstanding physician claims in accordance with the medical system's current standards (between 65 to 100 accounts daily)
- Identify missing information on forms
- And Knowledge of US Time zones associated to contact Healthcare Insurance
- Knowledge of automated utilization review and database analysis systems
- Maintain strict confidentiality; adheres to all HIPAA compliance and guidelines/regulations
- Awarded as “Young leader challenging associate”.
Education
B.com -
Mangalore University
Skills
Data Analysis
Claims Oversight
Workflow Optimization
Revenue performance
Customer Relationship Management
Team management
Project Planning
Operational Efficiency Management
Activities
- Badminton
- Football
- Cricket - Playing Cricket (Leather Ball) since 2007 as a Left Arm All-rounder with Karnataka State Cricket Association (KSCA).
- Represented Karnataka State U-16 from Bangalore Zone U-19 & U-23 from Mangalore Zone.
- Certified as '0' Level Coach from KSCA and worked as Coach for U-16 team in well-known academy 'Just Cricket'.
- Currently playing in Group 1 divisions from Bangalore.
Interests
Personal Information
- Father's Name: Dayanand N
- Mother's Name: Uma Devi C K
- Date of Birth: 10/21/94
- Marital Status: Married
Cricket
Cricket – Playing Cricket (Leather Ball) since 2007 as a Left Arm All-rounder with Karnataka State Cricket Association (KSCA).
Represented Karnataka State U-16 from Bangalore Zone U-19 & U-23 from Mangalore Zone.
Certified as "0" Level Coach from KSCA and worked as Coach for U-16 team in well-known academy "Just Cricket".
Currently playing in Group 1 divisions from Bangalore.
Software
Jaguar
Cerner Practice Management
Revenue Manager
Allscripts
Wasytar
3Cx
Timeline
Operations LEAD
Flatworld Solutions
05.2022 - Current
Assistant Operations manager
R1 RCM
08.2020 - 04.2022
PFS Team Lead
Cerner Healthcare
12.2016 - 08.2020
Analyst
Omega healthcare
08.2015 - 12.2016
B.com -
Mangalore University
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