NILESH UDOSHI
Bengaluru
Summary
Experienced healthcare industry professional with over 13 years of expertise in medical billing and the entire revenue cycle management (RCM) process. Seeking senior team lead/assistant manager positions in Bangalore, Pune, Belgaum, Hubli, and Dharwad. Graduate with a strong track record of success, bringing comprehensive knowledge of healthcare operations and a proven ability to optimize revenue generation. Skilled in leading cross-functional teams, implementing process improvements, and ensuring compliance with industry regulations. Committed to delivering exceptional results and driving organizational growth through strategic leadership and effective problem-solving.
Overview
16
16
years of professional experience
Work History
Client Specialist
ReSource Pro
02.2024 - Current
- Responded to all client inquiries and asked appropriate questions to facilitate resolution.
- Developed strong relationships with key clients, resulting in increased revenue and repeat business.
- Maintained detailed records of all client interactions, transactions, and correspondence, ensuring easy retrieval of information when needed and promoting transparency in communication across the team.
- Enhanced customer satisfaction by addressing and resolving complex issues in a timely manner.
- Interacted with team members across departments to research and resolve customer issues.
- Coordinated client onboarding processes, ensuring smooth transitions and minimizing disruptions.
- Streamlined processes for improved efficiency, implementing new systems for better client management.
- Trained new team members on best practices for managing client accounts, fostering a culture of continuous learning within the department.
Senior Lead - Medical Billing & Coding
Omega Healthcare
03.2021 - 01.2024
- Improved revenue cycle by managing and overseeing the entire medical billing process.
- Maintained compliance with industry regulations by staying current on changes in coding and billing practices.
- Implemented effective training programs for new hires to ensure consistent quality and performance standards.
- Increased accuracy in claims submissions, resulting in higher reimbursement levels.
- Effectively managed multiple priorities simultaneously while adhering to strict deadlines within a fast-paced environment.
- Streamlined billing procedures for increased efficiency and reduced errors.
- Collaborated with cross-functional teams, optimizing the overall medical billing process.
- Enhanced reimbursement rates by conducting regular audits of billing data.
- Implemented quality controls to prevent fraud or abuse in the medical billing system, safeguarding company resources and reputation.
- Oversaw daily operations for efficient workflow and productivity within the medical billing department.
- Managed a team of billing specialists, ensuring accurate and timely submission of claims.
- Conducted thorough reviews of denied claims, identifying root causes and implementing corrective actions.
- Served as a subject matter expert on medical coding, providing guidance to staff members when needed.
Team Lead Operations AR
Omega Healthcare
03.2017 - 11.2019
- Trained new team members by relaying information on company procedures and safety requirements.
- Promoted a positive work environment by fostering teamwork, open communication, and employee recognition initiatives.
- Served as a role model for the team by demonstrating commitment to excellence, professionalism, and adherence to company values at all times.
- Enhanced overall team performance by providing regular coaching, feedback, and skill development opportunities.
- Collaborated with other department leads to streamline workflows, improve interdepartmental coordination, and achieve business goals collectively.
- Evaluated employee skills and knowledge regularly, training, and mentoring individuals with lagging skills.
- Influenced positive change within the organization through strategic thinking, innovation, problem-solving abilities, and consistent leadership style.
- Managed schedules, accepted time off requests and found coverage for short shifts.
- Conducted regular progress reviews with individual team members to identify areas for improvement and provide guidance on career development opportunities.
- Managed risks and mitigated potential issues through proactive planning, monitoring, and timely decisionmaking.
- Established open and professional relationships with team members to achieve quick resolutions for various issues.
- Assisted in recruitment to build team of top performers.
- Generated reports detailing findings and recommendations.
- Frequently inspected production area to verify proper equipment operation.
- Provided reporting for forecast analysis and ad-hoc reporting in support of decision-making.
- Reduced attrition rates.
Quality Control Analyst
Omega Healthcare Management Services
01.2016 - 03.2017
- Conducted root cause analysis for recurring issues, developing long-term solutions to prevent recurrence.
- Provided training to new hires on quality control procedures, fostering a culture of excellence within the team.
- Improved overall production efficiency by identifying and resolving quality control issues.
- Conducted data review and followed standard practices to find solutions.
- Developed comprehensive documentation, maintaining accurate records of quality control results and actions taken.
- Supported continuous improvement initiatives by analyzing data trends and recommending process enhancements.
- Minimized down time Number% by reducing production rework and recalls.
- Analyzed quality and performance data to support operational decision-making.
- Created and revised procedures, checklists and job aids to reduce errors.
- Maintained adherence to SLA's in quality reviews.
- Cross-trained to support various quality assurance projects.
- Contributed to maintaining quality by attending regular calibration sessions.
AR Analyst
Advantedge Healthcare Solutions
02.2015 - 12.2015
- Prepared detailed analyses of key performance indicators to support management''s decision-making process related to collections strategies and credit policies.
- Coordinated with the credit department to evaluate new client creditworthiness and establish appropriate credit limits based on risk assessment criteria.
- Contributed to the development of new collection policies and procedures as part of continuous improvement initiatives within the AR department.
- Standardized AR reporting formats across business units for better comparability of results during performance reviews.
Senior Billing Associate - RCM
Btp Infoserve Pvt. Ltd
06.2009 - 01.2015
- Conducted monthly pre-billing review and data quality analysis to verify complete accuracy of invoices delivered to customers and providers.
- Reviewed full history of past due accounts and contacted client or attorney regarding collection, implementation of payment plan or pursuit of legal remedies on unpaid accounts.
- Submitted alternate billing for clients belonging to special demographics using Software software portal, reconciled EOBs or denied claims and conducted accounts receivable follow-up.
- Played a key role in system migrations or upgrades, ensuring seamless transitions from old platforms to new solutions with minimal disruptions to billing processes.
- Expedited payment collection through diligent follow-up on overdue invoices, establishing a consistent communication protocol with clients.
- Refined departmental procedures to promote consistency across team members while adhering to best practices in billing operations management.
- Elevated team performance through active participation in training sessions and staying current on industry developments related to billing practices or technologies used within the organization.
- Contributed to cash flow management by monitoring aging reports regularly and identifying trends in late or missed payments.
- Ensured compliance with company policies and industry regulations while managing sensitive financial data securely.
- Researched and resolved billing discrepancies to enable accurate billing.
- Handled account payments and provided information regarding outstanding balances.
- Conducted comprehensive quality assurance for claims.
- Managed EOBs and ERAs proficiently.
- Analyzed patterns in claim rejection and denial data.
Education
B.B.A/ B.M.S - Business Administration And Management
Indian Virtual University
Bengaluru01.2010
12th - Karnataka, English
01.2006
10th - Karnataka, English
01.2004
Skills
- Team Supervision
- Transition Management
- Team Coordination
- Process Transition
- Medical Coding
- US Healthcare
- Revenue Cycle Management
- Denials management
- QA/QC
- Operations Team Handling
- Team Leading
- People Management
- Team Management
- SLA Management
- Training
- Attrition Management
- Shrinkage Management
- First level Escalation Management
- Transition
- Client Relationship Management
- Client Onboarding
- Onboarding
Languages
English
Hindi
Kannada
Marathi
Hobbies and Interests
- Traveling
- Playing games
- Cooking
Timeline
Client Specialist
ReSource Pro
02.2024 - Current
Senior Lead - Medical Billing & Coding
Omega Healthcare
03.2021 - 01.2024
Team Lead Operations AR
Omega Healthcare
03.2017 - 11.2019
Quality Control Analyst
Omega Healthcare Management Services
01.2016 - 03.2017
AR Analyst
Advantedge Healthcare Solutions
02.2015 - 12.2015
Senior Billing Associate - RCM
Btp Infoserve Pvt. Ltd
06.2009 - 01.2015
12th - Karnataka, English
10th - Karnataka, English
B.B.A/ B.M.S - Business Administration And Management
Indian Virtual University
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