NEETHU KUMARI L
Mysore
Summary
Results-driven Healthcare Revenue Cycle Management professional with expertise in eligibility verification and authorization processes. Contributed to operational efficiency through innovative thinking and effective problem-solving skills. Focused on enhancing organizational success by fostering strong communication and collaboration across all levels.
Overview
7
7
years of professional experience
Work History
Group Leader
VaQya LLC
Mysore
05.2025 - Current
- Working as an Eligibility and Authorization Specialist for Rheumatology healthcare services.
- Handling prior authorization requests and ensuring compliance with insurance payer guidelines for Rheumatology treatments and procedures.
- Coordinating with insurance companies, provider offices, and patients to resolve authorization and coverage-related issues.
- Performing insurance eligibility verification to confirm patient coverage, benefits, co-pays, deductibles, and authorization requirements.
- Reviewing patient insurance details to ensure accurate and timely processing of services.
- Providing training and process guidance to new team members on eligibility verification and authorization workflows.
- Maintaining productivity, accuracy, and quality standards while meeting turnaround time (TAT) targets.
- Hands-on experience with healthcare applications including NextGen, CareCloud, and eClinicalWorks (ECW).
AR Analyst
Krystal 360 RCM
Mysore
10.2023 - 05.2025
- Managed unpaid and denied claims by analyzing denial reasons and executing follow-ups, ensuring timely reimbursement.
- Handled Radiology prior authorization processes and ensured compliance with insurance payer guidelines.
- Performed Eligibility Verification (EV) to confirm patient insurance coverage, benefits, and authorization requirements.
- Coordinated resolution of billing and authorization issues with insurance companies, provider offices, and patients.
- Worked on end-to-end Revenue Cycle Management (RCM) processes for Radiology healthcare providers.
- Hands-on experience with EMR/EHR and billing applications including Allscripts, Athena, Tebra, and Office Ally.
- Trained and mentored new team members on RCM workflows, claim processing, and application usage.
- Maintained accuracy, productivity, and quality standards, consistently meeting turnaround time (TAT) targets.
Senior AR Executive
Resolute Medical RCM
Mysore
10.2019 - 09.2023
- Worked on end-to-end Revenue Cycle Management (RCM) processes for Emergency Hospital Billing.
- Performed Accounts Receivable (AR) audits to identify aging claims and improve collection efficiency.
- Evaluated unpaid and denied insurance claims, identifying resolution paths for claim status, denial reasons, and payment discrepancies.
- Contacted insurance companies to verify claim status, resolve issues, and ensure timely reimbursement.
- Coordinated with insurance representatives, patients, and provider offices to resolve billing-related issues, enhancing overall claim resolution efficiency.
- Transferred outstanding balances to patients when insurance coverage was insufficient or not eligible.
- Monitored and tracked team performance metrics, ensuring alignment with productivity and quality standards.
- Conducted mock calls and provided process guidance to improve communication and claim handling skills.
- Trained new team members on company procedures, workflow processes, compliance, and safety requirements.
- Utilized Medisoft application for billing and account management tasks.
- Worked on TMS and RGS servers for claims processing and account follow-up.
Education
Karnataka Secondary Education -
St. Philomena's High School
Mysore01-2023
Board of Technical Education -
D.Banumaiah's Polytechnic College
Udayagiri, Mysore01-2014
Skills
- Revenue Software Developmentycle Management (RCM)
- Accounts Receivable (AR) Management
- Claims resolution
- Insurance Claim Follow-up
- Billing support
- Billing coordination
- AR Audits & Performance Tracking
- Eligibility verification
- Documentation compliance
- Time Management & Quality Assurance
- Team training
- Analytical communication
- Web Development
- Java Development
- System Administratio
Softwares
- Allscripts
- Athenahealth (Athena)
- Tebra
- Office Ally
- Medisoft
- NextGen Healthcare
- CareCloud
- eClinicalWorks (eCW)
- TMS Server
- RGS Server
Hobbies and Interests
- Dancing
- Listening to music
- Reading books
- Watching web series and international dramas
- Problem-solving puzzles and brain games
Languages
- English
- Kannada
- Hindi
Timeline
Group Leader
VaQya LLC
05.2025 - Current
AR Analyst
Krystal 360 RCM
10.2023 - 05.2025
Senior AR Executive
Resolute Medical RCM
10.2019 - 09.2023
Karnataka Secondary Education -
St. Philomena's High School
Board of Technical Education -
D.Banumaiah's Polytechnic College