Rajinder Singh Saini
Ghatkopar
Summary
Results-driven professional with expertise in Payer Outcomes Management and Accounts Receivable (AR) within the healthcare industry. Adept at analyzing payer reimbursements, optimizing revenue cycle management, and resolving complex accounts receivable issues to enhance financial performance. Skilled in developing strategies to improve payer relationships, reduce claim denials, and ensure timely and accurate payments. Proficient in leveraging data analytics to identify trends, streamline processes, and support organizational goals. Strong communicator with a deep understanding of healthcare regulations, insurance policies, and the nuances of payer contracts, ensuring compliance, and maximizing reimbursement opportunities. Proven ability to collaborate cross-functionally to drive operational efficiency and deliver measurable results in both payer outcomes and accounts receivable.
Overview
8
8
years of professional experience
Work History
Payer Outcomes Liaison
Trubridge
Mumbai
03.2022 - Current
- Finding Issues and Trends in Data.
- Comparing the spike in 90+ data on a monthly basis and conducting a deep dive analysis to provide resolution on highly impacted payers and trends.
- Helping the client build edits and rules in PM software based on payer requirements and changing guidelines.
- Worked on high-dollar accounts to eliminate delayed processing and payments.
- Based on projects and their conclusions, updates were brought into the process.
Senior RCR (Accounts Receivable)
Inventurus Knowledge Solutions
04.2018 - 03.2022
- Executed timely and accurate submission of claims for the Wind Down Project.
- Conducted thorough reviews of claims before forwarding them to the appropriate insurance companies.
- Managed follow-up on denied and rejected claims to maximize reimbursements.
- Reopened denied claims to ensure optimal recovery from insurance providers.
- Completed day-to-day duties accurately and efficiently.
- Maintained updated knowledge through continuing education and advanced training.
- Calling payers to discuss and find a resolution of denials impacting the claim.
Education
B.A.F -
G.N. Khalsa College
Mumbai, Maharashtra04.2017
H.S.C -
G.N. Khalsa College
Mumbai, Maharashtra02-2014
S.S.C -
Karthika High School
Kurla, Maharashtra03.2012
Skills
- Staff training and knowledge sharing
- Proactive problem solving
- Time management
- Decisive decision-making
- AR aging and denial management
- Cross-functional collaboration
- Task delegation
Personal Information
- Date of Birth: 08/17/96
- Gender: Male
- Marital Status: Unmarried
Hobbies and Interests
- Reading books
- Listening to music
- Travelling
Languages
- Punjabi
- English
- Hindi
Timeline
Payer Outcomes Liaison
Trubridge
03.2022 - Current
Senior RCR (Accounts Receivable)
Inventurus Knowledge Solutions
04.2018 - 03.2022
B.A.F -
G.N. Khalsa College
H.S.C -
G.N. Khalsa College
S.S.C -
Karthika High School