PREM KUMAR A

Senior Manager with overall 12 plus years’ experience in US Healthcare which will help me to explore myself fully and realize my potential, willing to work as a key player in challenging and creative environment where I can contribute to the successful growth of the organization this includes: Training and management of Healthcare Service Industry in the field of Medical Billing. Excellent analytical, problem solving, and communication skills. Ability to be an effective team player and work under severe time constraints. Team Mentoring and guidance in corporate behavior, process knowledge, etc. Ability to prioritize and organize. Versatile Senior Manager specializing and skilled at planning, implementing and overseeing key improvements to drive business growth and efficiency. History of cultivating an open culture with free exchange of information. Pursuing new professional challenges with a growth-oriented company.

• Client Interaction for the day to day activities.
• Co-ordination with Clients for the Completions & Status pending including any issues to be resolved.
• Handling smooth transition of new process.
• Handle end-to-end process in Medical Billing Cycle management (Demos, Charges, Cash Payment, AR Follow ups and AR calling) and ensure quality and timely delivery.
• Turnaround time to be maintained & adhered to, from the initial through the end process (TAT – 48/72 hrs for charges/payments).
• Handling around 40+ FTE’s involved in charge, payment, AR analysis and calling process.
• Tracking practice collection on a day today basis to monitor the collection trend.
• Strategic planning on manpower allocation across the processes.
• Plan and work towards increasing collections and decreasing Outstanding AR.
• Training & Managing a team involved in various processes of Medical Billing i.e., Analysis, Denial management & AR calling/Patient calling/Inbound.
• Coordinating closely with the AR follow-up team on issues and work out strategies to solve them.
• Provide periodic inputs to the team on current transaction process changes.
• Hands on experience in training newcomers on MBC (Medical Billing Cycle) client specifics & Telephonic etiquette which needs to be followed.
• Weekly Review of the accounts called & feedbacks given to the agents also identified bottom performers & provide necessary training.
• Knowledge of invoice preparation and creation of client and management reports.

• Maintaining compliance with all regulatory and accrediting institutions.
• Manage the credentialing needs for our clients.
• Collecting all the required documentation for credentialing such as accreditation, membership, and facility privileges (e.g., License, NPI letter).
• Assisting providers with completing payer forms and ensure compliance with payer’s expectations.
• Informing client providers and coaches informed about the status of their credentialing.
• Informing clients about new regulations, expiring certificates, reapplications, and deficiencies in credentialing requirements.
• Maintaining Re-credentialing due dates.
• Monitoring staff credentials and licenses.
• Participating in the development of internal credentialing processes.

• Delivered structured training programs on Revenue Cycle Management processes, including patient registration, billing, coding, and claims management.
• Trained staff on medical coding standards (ICD-10, CPT, HCPCS) and payer-specific billing requirements.
• Developed user-friendly training materials, including guides, presentations, and step-by-step workflow manuals.
• Conducted regular workshops and one-on-one coaching sessions to improve staff performance and reduce errors.
• Ensured compliance with healthcare regulations, such as HIPAA, Medicare, and Medicaid guidelines, through targeted training.
• Proficient in training employees on RCM software such as Epic, Cerner, or Athenahealth.
• Analyzed team performance metrics to identify knowledge gaps and customized training plans accordingly.
• Reduced claim denial rates by X% through effective training in denial management and resolution strategies.
• Led onboarding programs for new hires to ensure quick adaptation to RCM workflows and processes.
• Maintained training documentation and logs to track staff progress and ensure adherence to organizational standards.