Manoj Trivedi
Ahmedabad
Summary
Dynamic RCM professional with extensive experience at OmniISM Technologies, specializing in end-to-end revenue cycle management and denial resolution. Proven track record in optimizing workflows and enhancing client satisfaction through strategic consulting and strong communication skills. Adept at identifying growth opportunities, leading cross-functional teams, and driving process improvements to achieve exceptional results.
Overview
17
17
years of professional experience
Work History
Freelancer
Client Success & Business Development
Ahmedabad
04.2024 - Current
- Acted as the primary point of contact for clients, ensuring a smooth onboarding experience and ongoing satisfaction with medical billing services.
- Developed and maintained strong relationships with physicians, practice managers, and healthcare administrators to understand their needs and tailor solutions accordingly.
- Identified growth opportunities within existing accounts, resulting in increased revenue through up-selling and cross-selling services like credentialing, AR recovery, and coding audits.
- Led business development initiatives to acquire new physician practices and healthcare groups across the US through targeted outreach and strategic partnerships.
- Analyzed client revenue cycle performance, provided actionable insights, and implemented process improvements to optimize claim submission, reimbursement, and collections.
- Collaborated with internal teams (RCM, coding, AR follow-up, and tech support) to ensure timely resolution of client issues and service delivery excellence.
- Conducted market research and competitor analysis to refine go-to-market strategies and enhance service offerings.
- Negotiated contracts and service-level agreements (SLAs) while ensuring profitability and client satisfaction.
RCM Business Analyst
OmniISM Technologies Pvt. Ltd.
Ahmedabad
10.2022 - 03.2024
- Analyzed end-to-end RCM workflows including patient registration, charge capture, claim submission, payment posting, and denial management to identify automation and optimization opportunities.
- Collaborated with cross-functional teams (billing, coding, AR, and compliance) to gather and document business requirements for RCM software enhancements and new feature development.
- Translated complex business requirements into detailed functional specifications, use cases, and workflow diagrams for the product and development teams.
- Conducted gap analysis between current RCM system capabilities and evolving client/market needs, prioritizing enhancements and feature upgrades.
- Worked closely with software development and QA teams to ensure accurate implementation of billing logic, payer rules, and compliance standards.
- Led UAT (User Acceptance Testing) for RCM modules to validate end-user workflows and ensure error-free system functionality prior to deployment.
- Created and maintained documentation including BRDs (Business Requirement Documents), SOPs, and training guides for internal teams and clients.
- Interfaced directly with clients (hospitals, clinics, billing companies) to understand business challenges and provide tailored RCM system solutions.
- Monitored KPIs and reporting metrics such as Days in AR, First Pass Resolution Rate, and Clean Claim Rate to assess software performance impact.
- Supported change management and training efforts during new RCM system rollouts or upgrades.
- Ensured compliance with HIPAA, CMS guidelines, and payer-specific billing requirements across all software modules.
- Worked with product managers to develop the product roadmap based on evolving healthcare regulations and market demands.
Free Lancer
Medical Billing Specialist
Indore
08.2020 - 10.2022
- Managed end-to-end RCM processes including patient registration, eligibility verification, charge entry, claims submission, payment posting, denial management, and AR follow-up.
- Provided RCM consulting services to independent practices, specialty clinics, and billing companies to improve collections and reduce denials.
- Handled claim scrubbing and electronic/paper submissions across multiple payers ensuring clean claim rates above 98%.
- Performed extensive payer follow-ups on unpaid or underpaid claims, resolving issues to ensure maximum reimbursement.
- Led denial analysis and appeals process, successfully overturning high-dollar and complex denials across commercial and government payers.
- Ensured HIPAA compliance and maintained strict patient confidentiality across all client engagements.
- Set up and optimized billing workflows on platforms like Athenahealth, AdvancedMD, Kareo, DrChrono, eClinicalWorks, NextGen, and Practice Fusion.
- Trained and supervised junior billing staff and offshore teams on RCM best practices and client-specific guidelines.
- Conducted month-end reporting and KPI analysis for clients, offering actionable insights to enhance revenue performance.
- Managed multiple client accounts independently, ensuring timely submission of claims and consistent follow-up on aging AR.
- Provided credentialing and enrollment support for providers with commercial and Medicare/Medicaid payers.
- Specialized in multi-specialty billing including Internal Medicine, Cardiology, Orthopedics, Psychiatry, Family Practice, and Urgent Care.
- Assisted clients in identifying and fixing billing bottlenecks and compliance gaps, improving first-pass resolution rates.
- Maintained up-to-date knowledge of payer policy changes, ICD-10, CPT, and HCPCS updates, and industry best practices.
- Delivered high-quality client service, acting as a single point of contact for providers and administrative staff.
Project Lead / Manager
Clinical Excel Computech LLP
Ahmedabad
03.2018 - 08.2020
- Oversaw end-to-end revenue cycle management (RCM) projects, ensuring timely submission and follow-up of medical claims.
- Coordinated with clients (physicians, clinics, and billing teams) to gather requirements and define project scope, timelines, and deliverables.
- Implemented billing workflows and process improvements, increasing claims submission accuracy and reducing denials.
- Managed cross-functional teams (billing, coding, AR follow-up, and credentialing) to ensure seamless project execution.
- Conducted periodic performance reviews and shared detailed reports with stakeholders, ensuring transparency and accountability.
- Handled client onboarding and transition processes, including EHR/EMR setup, payer enrollments, and staff training.
- Monitored KPIs such as Days in AR, Clean Claims Rate, and Denial Rate to track project success and take corrective actions.
- Liaised with clients and internal teams to resolve escalations, ensuring high client satisfaction and retention.
- Maintained compliance with HIPAA and payer-specific billing guidelines.
- Utilized tools like Microsoft Project, Excel, and PM software (e.g., Trello, Asana) to track project milestones and resource allocation.
- Led regular internal and client meetings to discuss project status, risk mitigation plans, and performance metrics.
Billing Manager
Synergy Medsol Pvt. Ltd.
04.2017 - 03.2018
- Assisted in planning, coordinating, and executing medical billing projects to ensure timely and accurate claim submissions.
- Collaborated with cross-functional teams including coding, AR, and credentialing to streamline revenue cycle processes.
- Monitored project timelines, deliverables, and milestones, ensuring adherence to client-specific SLAs and compliance standards.
- Acted as a liaison between clients and internal teams to resolve billing issues and implement best practices.
- Conducted regular audits of billing workflows to identify inefficiencies and implement process improvements.
- Maintained and updated project documentation, status reports, and performance metrics for senior management.
- Supported onboarding of new clients and ensured smooth transition and knowledge transfer to operational teams.
- Managed task assignments, tracked project progress, and flagged potential risks or delays proactively.
- Assisted in training and mentoring junior staff on billing systems and project management protocols.
- Utilized project management tools (e.g., Trello, Asana, or MS Project) for effective task tracking and communication.
Senior Biller/Trainer for RCM
Omni ISM
Ahmedabad
06.2012 - 04.2017
- Company Overview: NY bases software Co
- Has its own EHR/PMS/RCM software
- Managing a RCM unit in Ahmedabad that includes RCM training, Credentialing, Enrollment, Payer Registration, end to end billing, support on billing as well as software
- A part of recruitment panel
- Attending technology calls with Tech team, BA team, QA team, Sales team and with the clients involved to create new RCM software
- Provide inputs and suggestions; approve the workflow for new software
- To held meetings with the existing clients and make them aware of the new changes in the software
- Reporting to manager for the daily activities carried out in India Office and also weekly Call with providers to discuss the status for their billing and also how can we improve our revenue efficiently by working on denials
- Majority of responsibilities involved the Billing aspects of Training and Support which also included getting the clients signed up with clearing houses, Insurance Master Set up for smooth running of processes, CPT Master set up and getting useful reports
- Being the person handling Project management I was also involved in the Office Set up
- NY bases software Co
- Has its own EHR/PMS/RCM software
Sr. Biller
INTEGRITY KNOWLEDGE SERVICES PVT LTD
Ahmedabad
05.2011 - 06.2012
- Company Overview: A new venture of Accurate Billing Services
- Was shifted to a newly opened branch of Accurate Billing Services Pvt Ltd
- Responsible for the billing (Charge, Payment and AR FU), training support for EMR Clients
- Responsible for Billing of few clients using our EMR Product
- Responsible for training of new employees Majority of responsibilities involved the Billing aspects of Training and Support which also included getting the clients signed up with clearing houses, Insurance Master Set up for smooth running of processes, CPT Master set up and getting useful reports
- Being the person handling Project management I was also involved in the Office Set up
- A new venture of Accurate Billing Services
Team Coordinator
Medusind Solutions Pvt. Ltd.
Ahmedabad
05.2008 - 04.2011
- Company Overview: A new branch formed as third party billing Co
- Has its branches in Chennai, Coimbatore, Delhi & Mumbai
- Joined the company as a trainee and was promoted to Team Co-ordinator
- Responsible for the Health Care processes for a providers' in New Jersey
- Job included client communication, dealing directly with Insurance companies and Appeal Departments for the rapid resolution of medical claims and eligibility
- Responsible for the AR recovery from insurance companies and Patients
- Verification of all payments posted to reduce errors and ease reconciliation
- Medusind Solutions Pvt Ltd is a third party billing company which uses the client's software and get the billing completed
- My job profile included the process to train the new joiners, Check Eligibility, Claim Submission, Clearing House rejections, Payment Postings and ERA's, Denial Management, AR's and Patient collections
- I was reporting directly to the General Manager who was next in hierarchy after me
- A new branch formed as third party billing Co
- Has its branches in Chennai, Coimbatore, Delhi & Mumbai
Education
Diploma in Business Management - Business Management
Maharashtra Institute of Tecnology
Pune04-2018
Diploma (Mech) -
IITE Institute
Valsad01.1997
SSC - subject
Mithapur High School
Mithapur01.1996
Skills
- End-to-End Revenue Cycle Management (RCM)
- Denial Management & Appeals Handling
- Accounts Receivable (AR) Analysis & Recovery
- Payment Posting & Reconciliation
- Insurance Verification & Eligibility Checks
- Compliance with HIPAA, CMS & Payer Guidelines
- Workflow Optimization & Automation (RCM tools)
- RCM KPI Tracking & Performance Reporting
- Project Planning & Execution
- Cross-Functional Team Leadership
- Change Management & Process Improvement
- EMR/EHR Integration & Management (Epic, eClinicalWorks, Kareo, Athena, etc)
- Client Onboarding & Implementation
- Account Management & Retention
- Performance Review Meetings & Reporting
- SLA Monitoring & Issue Resolution
- Strategic Consulting & Revenue Enhancement
- Client Needs Assessment & Custom Solutions
- Conflict Resolution & Stakeholder Management
- Upselling & Cross-Selling Value-Added Services
- Proposal Development & Contract Negotiation
- Market Research & Competitive Analysis
- Territory Expansion & Growth Planning
- Sales Forecasting & Revenue Planning
- Strong Presentation & Pitching Skills
- US Healthcare Market Understanding
- Excellent Communication & Interpersonal Skills
- Client-Centric Approach & Problem Solving
- Team Mentoring & Leadership
- Time Management & Prioritization
- Adaptability & Continuous Learning
- Analytical Thinking & Decision Making
- Negotiation & Influencing Skills
Languages
- English
- Hindi
- Gujarati
References
Any references or certificates required supporting any of the above mentioned experience or education can be produced on request.
Other Strengths
- Have worked on software's like QSI, HS Works, SQLMED, Meditab, OmniMD, NPN-RCM, Office Alli, Kareo, AdvancedMD and ECW (Partially)
- Good hold in MS Office
- Good knowledge of EMR, PMS and RCM
- Excellent domain Knowledge in US Healthcare Industry
- Excellent written and oral communication skills
- Information gathering and extracting the required out of it
- Performance equally good when independent as well as in team
- Very good with people Management
Personal Information
- Passport Number: Shall be provided
- Date of Birth: 12/08/82
- Gender: Male
- Nationality: Indian
- Marital Status: Married
Accomplishments
- Increased collections by 25% within 12 months by streamlining denial management workflows and reducing claim rejections through staff training and system audits.
- Reduced Days in AR by 30%, from 65 to under 45 days, by implementing aggressive AR follow-up strategies and improving payer communication protocols.
- Improved clean claim rate to 98% by enhancing charge capture accuracy, coding quality, and front-end eligibility checks.
- Onboarded 50+ physician practices across specialties (e.g., family medicine, radiology, urgent care), ensuring smooth transitions and minimal revenue disruptions.
- Led successful migration of RCM operations to a new EHR/PM system (e.g., eClinicalWorks, Kareo, AdvancedMD), resulting in improved billing efficiency and reporting accuracy.
- Recovered over $1M in aged AR by launching a focused AR clean-up project across multiple clients and assigning dedicated AR specialists by aging buckets.
- Achieved 100% client retention for 3 consecutive years through proactive performance reviews, personalized support, and continuous improvement initiatives.
- Spearheaded end-to-end revenue cycle setup for 10+ new clinics, from credentialing to patient intake workflows and insurance contracting.
- Implemented real-time dashboards and analytics tools, enhancing visibility into billing performance and helping clients make data-driven decisions.
Timeline
Freelancer
Client Success & Business Development
04.2024 - Current
RCM Business Analyst
OmniISM Technologies Pvt. Ltd.
10.2022 - 03.2024
Free Lancer
Medical Billing Specialist
08.2020 - 10.2022
Project Lead / Manager
Clinical Excel Computech LLP
03.2018 - 08.2020
Billing Manager
Synergy Medsol Pvt. Ltd.
04.2017 - 03.2018
Senior Biller/Trainer for RCM
Omni ISM
06.2012 - 04.2017
Sr. Biller
INTEGRITY KNOWLEDGE SERVICES PVT LTD
05.2011 - 06.2012
Team Coordinator
Medusind Solutions Pvt. Ltd.
05.2008 - 04.2011
Diploma in Business Management - Business Management
Maharashtra Institute of Tecnology
Diploma (Mech) -
IITE Institute
SSC - subject
Mithapur High School
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