Rahul Sharma
RCM Team Lead
Ghaziabad,UP
Summary
Profile Summary :
Experienced Team Lead with a strong background in project management, client relationship, and revenue analysis. Skilled in conflict resolution, workload management, and meeting SLA deliverables. Proficient in Ms Office applications and deadline-oriented with a focus on collection strategy and total productive maintenance.
- RCM Professional offering rich & Qualititave Experience of over 12 Years
- Extensive Domain Knowledge in the field of RCM(Billing, Payment Posting, Collections, Credit Balance, Reconciliations, Month End reporting & Record to Report)
- Knowledge of O2O conversation while sharing the annaully rating.
Overview
12
12
years of professional experience
2
2
Certifications
Work History
Team Lead
Getix Health India Pvt Ltd
02.2019 - Current
- Facilitated collaboration between cross-functional teams to ensure successful completion of project milestones.
- Cash posting started with 5 clients indulging 2 FTEs and didn't lost any clients beacuse of escalations.
- Managing the process of Cash Posting, Credit Balances & Charge Posting.
- Utilizing 19 FTEs to manage the process. working on 85 clients to collect $9.00M average.
- Managing 2 direct clients since 2019. Which is very valuable and collected average $800k every Month.
- Dailiy Huddle to update the Team
- SOP & PPTs Creation
- Daily Touch Base call with Company's Sr. VP, Leader ship Team, Direct client & US Account Managers
- Proficient in prepare following reports:
EDI Analyst
Emds (Formely Known as CGM ARIA)
04.2015 - 02.2019
As a Sr. Claim Associate at Emds (Formerly Known as CGM ARIA), As a Team player in processing healthcare claims and implemented efficient collection strategies. I demonstrated strong team bonding in managing workloads and achieving SLA deliverables.
- Promoted as EDI analyst after 1.5 years after going through the IJP process.
- Worked on Trizetto rejection and set up along with the charges & Payment Team to prevent the rejections
Billing Associate
Pacific BPO, An Access Healthcare
06.2014 - 04.2015
- Investigated of Denial reason with the denial Code mentioned on the EOB and payment posting.
- Worked as a claim management executive for payment posting and denial posting
- Handled the team queries
- Created the day end report, Master Log, P2P status along with the pending workload
Associate
E4E Healthcare Business, Known as Savista Global
08.2012 - 06.2014
- Learnt the US Health care Process, RCM workflow & Medical Billing
- Build the knowledge of medical Claims, Cash Posting, Charge posting, Insurance Verification & eligibility.
- Understood the process of impact of claim denial and provider Revenue
- Learnt the Medical Terminology
Education
Master of Commerce -
IGNOU
New Delhi, India 04.2001 -
Bachelor of Commerce -
Delhi University
Delhi 04.2001 -
Skills
Operations Management
Performance monitoring
Coaching and Mentoring
Quality Control
Project Management
Revenue Analysis
Client Relationship
Workload Management
Conflict Management
FTEs Utilization
Capacity VS Capability
MS Office
Clients Delivarables
Certification
Leadership Devolpment Program
Timeline
Leadership Devolpment Program
12-2023
LSSYB
06-2023
Team Lead
Getix Health India Pvt Ltd
02.2019 - Current
EDI Analyst
Emds (Formely Known as CGM ARIA)
04.2015 - 02.2019
Billing Associate
Pacific BPO, An Access Healthcare
06.2014 - 04.2015
Associate
E4E Healthcare Business, Known as Savista Global
08.2012 - 06.2014
Master of Commerce -
IGNOU
04.2001 -
Bachelor of Commerce -
Delhi University
04.2001 -