Playing sports (especially football)
RAHUL KUMAR
AR Collection Representative | RCM Specialist
Noida
Summary
Results-driven professional with extensive experience in lead generation, claims representation, and accounts receivable collections (RCM), complemented by a B.Sc. in Non-Medical and a Master of Computer Applications (MCA). Expertise in managing comprehensive revenue cycle processes, resolving complex claim-related issues, and ensuring timely collection of accounts receivable. Proficient in data analysis, customer query resolution, and effective coordination with insurance providers while maintaining exceptional accuracy in documentation. Recognized for strong problem-solving abilities and communication skills, thriving in fast-paced, target-oriented environments with a commitment to delivering quality outcomes and enhancing operational efficiency.
Overview
5
5
years of professional experience
3
3
Languages
Work History
AR Collection Specialist
Optum, UnitedHealth Group
10.2024 - Current
- In AR Collections Specialist i was responsible for managing and collecting outstanding insurance claims, denials, and patient balances to optimize cash flow for the organization. This role focuses on resolving unpaid or underpaid claims, appealing denials, and ensuring compliance with payer policies and healthcare regulations (e.g., HIPAA, CMS guidelines).
Enrollment Associate
Optum, UnitedHealth Group
10.2022 - 10.2024
- In Enrollment Associate, responsible for accurately processing and managing member enrollments, changes, and terminations in compliance with company policies and healthcare regulations (e.g., HIPAA, ACA). This role ensures seamless onboarding of members, resolves enrollment discrepancies, and provides excellent customer service to clients, brokers, and internal teams.
- Enrollment Processing: Accurately input and verify member enrollment data into the system. Process new enrollments, changes (e.g., dependents, coverage tiers), and terminations. Ensure timely and error-free submission of enrollment files to carriers.
- Compliance & Documentation: Adhere to HIPAA, ACA, and other regulatory guidelines. Validate eligibility documents (e.g., SSNs, birth certificates, proof of residency). Maintain organized records of enrollment transactions.
Lead Generation Specialist
ISKPRO, Inc
04.2021 - 09.2022
- In the Lead Generation Specialist role, I was responsible for identifying, qualifying, and nurturing potential clients (leads) for the company's web design and digital marketing services. This role involves researching prospects, initiating contact via multiple channels (email, calls, social media), and converting leads into sales opportunities for the business development team.
Education
Bachelor of Science -
DR. A.P.J. ABDUL KALAM UNIVERSITY
Indore, MP 04.2001 -
Master of Computer Applications(MCA) - Computer Software
MAHARAJA AGRASEN HIMALAYAN GARHWAL UNIVERSITY
UTTARAKHAND(IND) 04.2001 -
HARTRON DIPLOMA IN COMPUTER SOFTWARE - HARTRON DIPLOMA IN COMPUTER SOFTWARE
HARYANA STATE ELECTRONICS DEVELOPMENT CORP. LTD.
HISAR (HARYANA) 04.2001 -
Skills
- Microsoft office Excel
- Microsoft office
- SQL
- Email Marketing
- Claims processing / AR COLLECTION (RCM)
- HTML
- Customer service
- Power BI
- Strong negotiation skills
- Collection strategy development
Interests
Watching movies
Listening to music
Reading books
Timeline
AR Collection Specialist
Optum, UnitedHealth Group
10.2024 - Current
Enrollment Associate
Optum, UnitedHealth Group
10.2022 - 10.2024
Lead Generation Specialist
ISKPRO, Inc
04.2021 - 09.2022
Bachelor of Science -
DR. A.P.J. ABDUL KALAM UNIVERSITY
04.2001 -
Master of Computer Applications(MCA) - Computer Software
MAHARAJA AGRASEN HIMALAYAN GARHWAL UNIVERSITY
04.2001 -
HARTRON DIPLOMA IN COMPUTER SOFTWARE - HARTRON DIPLOMA IN COMPUTER SOFTWARE
HARYANA STATE ELECTRONICS DEVELOPMENT CORP. LTD.
04.2001 -