Raghavendra Desai
Senior Process Expert
Bangalore
Summary
Senior Process Expert specializing in denial management, AR follow-up, and appeals for healthcare revenue cycle workflows. Reviews denied claims, coordinates with payers, and works with billing and coding teams to correct errors, resubmit claims, and protect reimbursement. Supports onboarding and training while maintaining documentation and compliance across Federal and Commercial payers.
Overview
5
5
Languages
1
1
Certification
7
7
years of professional experience
Work History
Senior Process Expert
Provana India Pvt. Ltd.
Chennai
05.2024 - Current
- Analyzed and reviewed denied claims to identify root causes and recurring trends, enhancing overall claims processing accuracy.
- Coordinated with insurance companies to resolve claim denials, facilitating timely reimbursement and improving cash flow.
- Analyze and review denied claims to identify root causes and recurring trends.
- Collaborate with billing and coding teams to correct claim errors and resubmit claims.
- Prepare and submit appeal letters with supporting documents for denied claims.
- Utilize denial management and EDI software such as ECW, EZ Billing, and DME Project tools.
- Ensure compliance with healthcare regulations and ethical standards.
- Supported and mentored new team members during onboarding and training, fostering a knowledgeable and efficient team environment.
- Handle both Federal and Commercial payer claims efficiently.
Pre-Sales & Inside Sales Associate
Think & Learn Pvt. Ltd. (BYJU'S)
Bangalore
06.2021 - 10.2022
- Conducted outbound calls to prospective customers, generating qualified leads that contributed to sales pipeline growth.
- Maintained customer databases and tracked sales activities to ensure accurate reporting and follow-up.
- Understood customer requirements and explained product features effectively.
- Assessed customer requirements and communicated product features to align solutions with needs.
- Prepared weekly and monthly sales reports using MS Excel.
Senior Business Development Executive
Extramarks Education India Pvt. Ltd.
10.2020 - 12.2020
- Guided students in defining career and educational goals, enhancing their clarity and focus.
- Assisted students in course selection and academic planning.
- Identified student strengths and areas of improvement.
- Maintained comprehensive enrollment and progress reports to track student development and success.
- Connected students with counselors and academic support resources.
- Ensured compliance with institutional policies and procedures, safeguarding integrity and standards.
Senior Academic Counselor
Vedantu Innovation Pvt. Ltd.
01.2020 - 04.2020
- Counseled students on academic and career development to enhance their educational pathways.
- Assisted students with course selection and study planning.
- Prepared and analyzed weekly and monthly academic progress reports to track student performance and identify improvement areas.
- Provided support to students facing academic or behavioral challenges.
- Coordinated with counselors and tutors to implement strategies that supported student success.
Education
Bachelor of Business Administration -
Karnataka University
Dharwad01-2018
Skills
Denial management
Ar follow-up
Eligibility verification
Revenue cycle management
Appeals & documentation
Insurance claims processing
Claims denial analysis
Payer communication
Claim resubmission
Denial tracking reports
Certification
SDET Testing Course
Timeline
Senior Process Expert
Provana India Pvt. Ltd.
05.2024 - Current
Pre-Sales & Inside Sales Associate
Think & Learn Pvt. Ltd. (BYJU'S)
06.2021 - 10.2022
Senior Business Development Executive
Extramarks Education India Pvt. Ltd.
10.2020 - 12.2020
Senior Academic Counselor
Vedantu Innovation Pvt. Ltd.
01.2020 - 04.2020
Bachelor of Business Administration -
Karnataka University
Declaration
I hereby declare that the information provided above is true and accurate to the best of my knowledge.