MURUGANANTHAN P
Supervisor_RCM-Quality
Summary
Dynamic professional with 12 years of experience in US healthcare and insurance, adept at navigating diverse domains and embracing challenges. Proven expertise in communication, project management, and agile learning. Ready to leverage my extensive background and skills in a new career stage, eager to contribute to innovative projects and drive impactful results.
Overview
11
11
years of professional experience
Work History
Supervisor -Compliance Auditing (Quality)
Med Expert Health Pvt Ltd
9 2023 - Current
- Domain: US Healthcare: Well-versed in ambulance billing for Emsmart and the RNB platform
- All client escalation mail responses were given from my end
- Handling more than 300 clients and allocating them on a daily basis
- I am handling 25 members of my team for billing and coding, payment posting, data entry, and follow-up
- Work delegation and user allocation as per the inflow of records
- Monitoring team attendance on a daily basis
- Daily conducting meetings with the team
- Handling the production and quality databases on a daily basis
- Given training to the new users regarding the client-specific software and process
- Preparing the dashboard for the entire process of conducting QA sessions every week
- Creating RCA reports based on that will implement BQ performance plant to improve the quality
- Handling Leave Planner and EWS Report
- Handling onshore team meetings on a daily basis
- Implemented QMS tool and identifying the issues and resolve.
Quality Analyst-Credit Balance
Legacy Health Pvt Ltd
02.2018 - 04.2023
- Domain: Hospital Billing_US Healthcare: Well knowledge in Posting Payments and Credit balance in AdvantX
- Auditing patient & Insurance Refunds and send approval
- All Client Escalation Mails response given from my end
- Preparing Patient and Insurance refunds on daily basis defends upon inflow
- All Patient & Insurance refunds upload to client portal on daily basis
- Work delegation and User Allotment as per inflow of records
- Monitoring Team Attendance on daily Basis
- Handling Production & Quality Database on daily basis
- Taken training to the new users regarding the client specific software and process.
Subject Matter Expert
EXL Services India Pvt Ltd
05.2013 - 11.2017
- Domain: Provider Billing_US Healthcare: Well knowledge in Posting Payments and Denial in CHI Allscripts, Epic, Group cast
- Analyze the denial reason from EOB and kick the appropriate denial Reasons
- Taken training to the new users regarding the client specific software and process
- Handling a team of 30 Members as a SME role
- Received Rewards and Recognition as a good team player
- Interacting with US clients regarding SOP updates and Queries and sharing to the team
- Work delegation and User Allotment as per inflow of records
- Trained in End to End Process in All scripts
- Monitoring Team Attendance on Daily Basis
- Handling Production Database on daily basis for my Team.
Claim Analysis Sr .Representative
Dell International Services India Pvt Ltd
- 04.2012
- Domain: Provider Billing_US Healthcare: Initially I was put in Denial & Payment Posting
- Clarifying doubts for the new associates regarding the process
- Received Rewards and Recognition as a good team player
- Analyze the denial reason from EOB and kick the appropriate denial Reasons.
Education
B.COM Commerce -
University of madras
Diploma in MOP - undefined
State Institute of Commerce Education
10th - undefined
Govt High School Naduvalur
Skills
Typing in English (High Grade)
Personal Information
- Date of Birth: 05/30/92
- Gender: Male
- Nationality: Indian
- Marital Status: Married
Languages
English, Tamil, Malayalam, Telugu
Disclaimer
I hereby declare that all the statements made in the application are true, complete and correct to the best of my knowledge and belief.
Timeline
Quality Analyst-Credit Balance
Legacy Health Pvt Ltd
02.2018 - 04.2023
Subject Matter Expert
EXL Services India Pvt Ltd
05.2013 - 11.2017
Supervisor -Compliance Auditing (Quality)
Med Expert Health Pvt Ltd
9 2023 - Current
Claim Analysis Sr .Representative
Dell International Services India Pvt Ltd
- 04.2012
B.COM Commerce -
University of madras
Diploma in MOP - undefined
State Institute of Commerce Education
10th - undefined
Govt High School Naduvalur
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