Summary
Overview
Work History
Education
Skills
Accomplishments
Languages
Personal Information
Awards and Recognitions
Extracurricular Activities
Certification
Hobbies
Disclaimer
Software
Timeline
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NITHEESH KUMAR G.N.

SME - Hospital billing

Summary

Dedicated and results-oriented professional with extensive experience in medical billing and revenue cycle management. Proven ability to handle high-dollar claims, resolve denials, and contribute to team training. Seeking to leverage expertise in a dynamic organization for mutual growth. Experienced professional driven to optimize processes and streamline operations for team efficiency. Decisive leader with an analytical and flexible approach to solving problems. Hardworking professional, enthusiastic about take on exciting new challenges. Dynamic communicator with disciplined approach.

Overview

5
5
years of professional experience
1
1
Certification

Work History

Senior Associate – Claim's Coordinator

Corrohealth Pvt Ltd
7 2023 - 7 2024
  • Coordinated the healthcare claims process, managing authorizations, creating and approving retro authorizations, and escalating special approval requests to the appropriate department, while ensuring compliance with regulatory standards and providing exceptional support to providers and members.
  • Oversaw attendance tracking, leave management, and report generation to optimize team performance and efficiency, while effectively managing client escalation emails to ensure swift resolutions.

Subject Matter Expert

Coronis Healthcare Pvt Ltd
09.2022 - 07.2023
  • Led a high dollar claims resolution team, generating over a million dollars monthly; managed team operations including attendance tracking, resource allocation, and report generation to enhance performance and efficiency
  • Interacted with clients to understand their needs and effectively cascaded tasks to team members, ensuring alignment and timely delivery of project goals
  • Contributed to hospital and physician billing projects, utilizing software such as EPIC, Kareo, eCW and Cerner to streamline processes and enhance accuracy.

Senior Client Partner (AR Caller)

Access Healthcare
03.2022 - 09.2022
  • Developed client relationships and enhanced service delivery for healthcare providers
  • Contributed to hospital billing projects, utilizing software such as EPIC to streamline processes and enhance accuracy.

Process Associate (AR Caller)

Guidehouse India Pvt Ltd
08.2019 - 03.2022
  • Handled insurance claim submissions and follow-ups, resolving denied claims efficiently
  • Contributed to hospital and physician billing projects, utilizing software such as Meditech and Cerner to streamline processes and enhance accuracy.

Process Associate (AR Caller)

Prochant India Ltd
05.2018 - 08.2019
  • Began my medical billing career at Prochant, specializing in end-to-end revenue cycle management (RCM) for DME billing projects
  • My responsibilities included billing, denial management, and resubmitting claims with coding and billing corrections by analyzing denials to facilitate successful claim appeals for payment.

Education

Bachelor of Computer Applications (BCA) -

Nesamony Memorial Christian College, Marthandam

XII Standard - undefined

Good Shepherd H.R. Sec. School, Marthandam

X Standard - undefined

Ambiance Public School, New Delhi

Skills

Team Leadership

Accomplishments

  • Achieved highest revenue collection for high dollar accounts in January 2023.
  • Recognized for outstanding contributions to team success and training initiatives.

Languages

English, Malayalam, Hindi, Tamil
Bilingual or Proficient (C2)

Personal Information

  • Age: 29
  • Father's Name: Gopala Krishnan
  • Mother's Name: Nirmala
  • Date of Birth: 07/01/95
  • Gender: Male
  • Nationality: Indian
  • Marital Status: Single

Awards and Recognitions

  • Improved claim resolution time by 20% by adding a time tracker.
  • RCM certified vendor for HUMANA (07/01/23 – 07/01/24)

Extracurricular Activities

Coordinated various events at school and college. 

Camp Senior for Army Attachment Camp, 1/9 GR, Secundrabad, Telangana. 

Active member of NCC, achieved B+ in B Certificate and A in C Certificate.

Certification

Certified RCM vendor for Humana

Hobbies

  • Cooking: Enjoy cooking for my family.
  • Bike Riding: Prefer solo rides as a way to relax and recharge.
  • Badminton: Occasionally play with friends.
  • Movies: Avid movie enthusiast, enjoying a variety of genres.
  • Socializing: Enjoy attending parties and gatherings with friends.

Disclaimer

I hereby declare that all information provided above is true to the best of my knowledge and belief.

Software

EPIC, Cerner, Kareo, eCW, Bright tree

Timeline

Certified RCM vendor for Humana

07-2023

Subject Matter Expert

Coronis Healthcare Pvt Ltd
09.2022 - 07.2023

Senior Client Partner (AR Caller)

Access Healthcare
03.2022 - 09.2022

Process Associate (AR Caller)

Guidehouse India Pvt Ltd
08.2019 - 03.2022

Process Associate (AR Caller)

Prochant India Ltd
05.2018 - 08.2019

Senior Associate – Claim's Coordinator

Corrohealth Pvt Ltd
7 2023 - 7 2024

Bachelor of Computer Applications (BCA) -

Nesamony Memorial Christian College, Marthandam

XII Standard - undefined

Good Shepherd H.R. Sec. School, Marthandam

X Standard - undefined

Ambiance Public School, New Delhi
NITHEESH KUMAR G.N.SME - Hospital billing