Lohith M D
Bengaluru
Summary
Results-driven Senior AR Analyst(4.5 years) with extensive experience at Calpion Software Technologies, specializing in denial management and claims resolution. Proven ability to analyze EOBs and enhance billing accuracy, while mentoring teams to improve operational efficiency. Proficient in ModMed RCM software and skilled in effective communication with US-based payers.
Overview
9
9
years of professional experience
Work History
Senior AR Analyst
Calpion Sofware Technologies
Bengaluru
08.2024 - Current
- Analyze and resolve A/R issues for assigned clients.
- Conduct audits of medical billing claims for accuracy and quality.
- Read EOBs, identify denials, and resolve claims.
- Call US insurance companies to follow up on unresolved or denied claims.
- Analyze reports to identify trends and recommend quality improvement.
- Track client issues and suggest enhancements.
- Support automation and process improvements.
- Mentor and train new or less-experienced associates.
- Conducted detailed audits of quality control processes and compliance standards.
Senior Process Executive
Cognizant Technology Solutions India Pvt Ltd
Bangalore
10.2021 - 11.2023
- Analyze and discover root causes for medical insurance claim denial, underpayment, or delay.
- Monitor and reconcile all over age accounts.
- Analyze data to discover denial patterns, plan and execute medical insurance claim denial appeal process.
- Precisely evaluated and verified benefits and eligibility.
- Located errors and promptly refiled rejected claims.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Filed and updated patient information and medical records.
- Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Interact with US-based practice owners and clinicians on completing and correcting any missing or incorrect data on their insurance claims.
- Communicated effectively and extensively with other departments to resolve claims issues.
AR Associate
OMEGAHEALTHCAREMANAGEMENTSERVICES
Bangalore
03.2019 - 04.2020
- Filed and updated patient information and medical records.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Posted payments and collections on regular basis.
- Adhered to established standards to safeguard patients' health information.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
Graduate Apprentice Trainee
L & T CONSTRUCTION EQUIPMENT LIMITED
Doddaballapur
05.2017 - 03.2018
- Helped team carry out action plans to improve service metrics and outcomes.
- Maintained customer service standards for department and company at large.
- Followed company policies and government regulations to satisfy operational compliance requirements.
- Finished assigned work on schedule with minimal supervision.
- Maintained up-to-date knowledge and information about technology and plant management best practices.
- Worked with quality manager to achieve the proper segregation and recycling of all wash and rework.
Education
Bachelor of Engineering - Mechanical Engineering
Goverment Engineering College Hassan
Hassan, KA08-2016
Skills
- US Healthcare A/R & RCM
- Denial Management
- Claim Follow-up
- Medical Billing Audits
- Explanation of Benefits (EOB) Analysis
- Insurance Calling (US-based Payers)
- Accounts receivable
- Claims resolution
- ModMed RCM software
- NextGen RCM software
Timeline
Senior AR Analyst
Calpion Sofware Technologies
08.2024 - Current
Senior Process Executive
Cognizant Technology Solutions India Pvt Ltd
10.2021 - 11.2023
AR Associate
OMEGAHEALTHCAREMANAGEMENTSERVICES
03.2019 - 04.2020
Graduate Apprentice Trainee
L & T CONSTRUCTION EQUIPMENT LIMITED
05.2017 - 03.2018
Bachelor of Engineering - Mechanical Engineering
Goverment Engineering College Hassan