Ramvijay Singh
Dombivali East
Summary
Experienced in Operations, leading billing initiatives in Revenue Cycle Management for enterprise clients with a rich background spanning 13 + years. Currently overseeing a team of 150 employees, I bring proven expertise in optimizing billing processes to maximize revenue generation and ensure financial efficiency. Known for a strategic approach to team leadership, fostering a collaborative environment, and implementing solutions that enhance operational performance. Proficient in navigating the evolving regulatory landscape of the healthcare industry. Committed to maintaining the highest standards of accuracy, compliance, and client satisfaction. Eager to contribute my extensive experience to an organization seeking a dedicated and experienced professional.
Overview
14
14
years of professional experience
2
2
Certifications
Work History
Client Success Partner
Medico Healthcare Services
03.2024 - Current
- Collaborated with clients to understand their revenue cycle challenges and develop customized solutions to improve billing efficiency and maximize revenue.
- Managed the onboarding process for new healthcare provider clients, ensuring seamless transitions and high client satisfaction.
- Led monthly/quarterly business reviews to review performance metrics, discuss strategic initiatives, and identify opportunities for improvement.
- Provided training and support to clients on new technologies, software updates, and industry best practices.
- Managed a team of revenue cycle specialists, providing coaching, training, and performance evaluations.
- Developed and maintained key performance indicators (KPIs) to monitor operational performance and drive continuous improvement initiatives.
- Implemented process improvements that reduced claim denials by 20% and accelerated cash flow.
- Leading a team of 150 employees with 3 Assistant Manager and 6 Team Leader.
- Analyzed data and metrics to provide insights and recommendations for enhancing client success and achieving business goals.
- Oversee the approval of incentive programs and overtime requests, ensuring alignment with budgetary and performance goals.
Team Lead
E Clinical Works
04.2016 - 03.2024
- Practice KPI: Prepare monthly practice KPI which includes metrics of charges, denials, rejections, Payment liquidation, ERA versus EOB posting, Top Performers and issues related to 3P.
- Weekly Denials & Rejection Trend Report: Prepare weekly report on Denials and rejections to understand the trend and work on creating rules to control rejection and denials and at the same time share the feedback with client on areas where we need help from client to control denials and rejections which helps in revenue increase.
- Payment Report: Prepare a payment report on weekly basis and check whether we are receiving payments from payers as per the expected weekly benchmark and work on those inventories where we have not received payments from payer.
- Statistical Process Control Report: Prepare a process control report on weekly basis for continuous improvement in process and monitor the process and take a proactive measure wherever needed.
- Appraisals: Conducting thorough and constructive performance appraisals to recognize achievements, address areas for development, and foster continuous growth within the team.
- One on One & Performance Evaluation: Conducting monthly One on One and Performance evaluation with the team members to provide the monthly feedback about their quality and production at the same time plan their training needs based on their performance.
- Weekly Client Call: Proactively engaging in weekly client calls to ensure transparent communication, address concerns, and maintain a strong collaborative partnership.
- Client Training: Delivering comprehensive training sessions to clients on Revenue Cycle Management processes to enhance understanding and promote seamless collaboration.
- Onboarding New Client: Leading the onboarding process for new RCM clients, ensuring a smooth transition by aligning systems, educating on processes, and establishing a collaborative partnership for optimal financial outcomes.
- Claim Error Report: Review the claim error report weekly and monthly to increase the FPR.
- Cash Flow Monitoring Analysis: Checking the claims which are resulting into rejections and categorizing those rejections into operational, Product, Eligibility Workflow issue which will help to reduce the rejections of the practice and increase the first pass ratio of the claims.
- RCM Hand Book: Was responsible to provide the handbook data consist of Charges, denials, payments,90+and challenges, accomplishment and initiatives.
- Jopari Weekly Call: Going on Jopari call on weekly basis to resolve the internal queries received from operations and get the resolution on those areas suggesting product improvement features to Jopari which will help operation to bring more efficiency while working on rejections and tracking report.
- Inventory Management Production Validation: Follow up on all the escalation & provide feedback to team on incorrect movement. Coordinate with AMRC team to have quick resolution.
- Validating the possibility of electronic connections of payers for 276/277 & WebCrawler.
- Cross check inventory status through the system/Ebo report to ensure production SLA has been met.
- Follow up on tasks and actions created for the exception as these needs to be closed before month end.
- Closing all payment Exceptions on 25th of every month for smooth hard close.
- All aspects of A/R: Focusing on collections and days in AR.
- Follow-up on all escalations till resolution.
- Training staff, monthly and weekly meetings.
- Enrollment & Credentialing weekly report.
- Ensure strict HIPPA compliance.
- Reviewed employee timesheets.
- Handling team of 35 employees.
Mentor
E Clinical Works
09.2013 - 03.2016
- Managing Production.
- Doing Quality and sharing quality feedback with team weekly.
- Managing the team with strength of 20.
- Sharing weekly feedback on denials.
- Identifying Knowledge gap and Training team on aspects where they lack.
- ANSI batch creation and submission on clearing house.
- Handling special projects for eligibility enrollment with Insurance and clearing house.
- Handling claims with different insurance.
- Creating suedo Batches to avoid any batch level rejection.
- Keeping a track on payments received on weekly basis and sharing the summary to practice if there is a dip in collection or encounter locked.
- Correction of denials claims with accurate information and re-submission of all claims.
- Make sure that team adheres to follow up on unpaid claims.
- Biweekly doing practice Health Analysis.
- Making team work on 90 + inventory on Priority.
RCM Executive
E Clinical Works
04.2012 - 09.2013
- Follow up on Denied and in process inventory.
- Posting of denials and any necessary adjustments from deductibles and denials.
- Monitor accounts for data entry errors and accurate insurance information.
- Website Creation of Payers.
- Insurance calling to resolve posting exceptions.
- Trained new joiners on PM and Billing Screen.
- Research payments for short pays.
- CH & Payer Rejections.
AR Analyst
Medusind Solution
04.2011 - 09.2011
- Denied and unpaid claims.
- Preparing Appeals for denied claims.
- Monitor accounts for data entry errors and accurate insurance information.
- Insurance appeals and claims corrections as needed.
- Patient Calling.
- Insurance appeals and claims corrections as needed.
Education
B.SC - IT
University of Mumbai
12TH - undefined
Thakur College of Sci
10TH - undefined
St Anthony's High School
Skills
Billing Optimization
Certification
Green Belt in Six Sigma
Awards
- Rising Star 2012 as an Executive
- All Time Star 2014 as an Executive
- All Time Star 2015 as a Mentor
- Rising Star 2016 as a Team Lead
- All Time Star 2017 as a Team Lead
Notable Career Highlights
- Worked in Jopari Project (Electronic Submission of Workers comp claims).
- Use to gather the rejection data and provide feedback to operations teams in initial stage and have a weekly meeting with Jopari to get the answers of operational challenges which was faced during implementation.
- Suggested the data element and prepared the report which was useful to track the rejections and aging of a claims which got submitted via Jopari.
- Created a rule on PM to stop the incorrect submission of claims to Jopari.
- Trained operations team on Jopari and the workflow to be follow while doing claims submission for Workers' comp and Auto Insurance.
- Post successful implementation of Jopari to PM it resulted around 8 % of reduction in paper submission claims of Workers comp and Auto Insurance.
EHR &PM
Worked on ECW
Advanced MD
Wound Expert
Nymble
Epic
ModMed
PCC
Athena
Timeline
Client Success Partner
Medico Healthcare Services
03.2024 - Current
Team Lead
E Clinical Works
04.2016 - 03.2024
Mentor
E Clinical Works
09.2013 - 03.2016
RCM Executive
E Clinical Works
04.2012 - 09.2013
AR Analyst
Medusind Solution
04.2011 - 09.2011
B.SC - IT
University of Mumbai
12TH - undefined
Thakur College of Sci
10TH - undefined
St Anthony's High School
Similar Profiles
Abdul Gaffar MohammadAbdul Gaffar Mohammad
Senior Team Lead at Medico Healthcare services & TechnologiesSenior Team Lead at Medico Healthcare services & Technologies
KUNDAN MISHRAKUNDAN MISHRA
Customer Success and Service Delivery Manager at Medico healthcare services And TechnologiesCustomer Success and Service Delivery Manager at Medico healthcare services And Technologies
KANAGARLA KESAVAKANAGARLA KESAVA
Senior Process Associate at Infinx services private limitedSenior Process Associate at Infinx services private limited
Arun Abhayraj YadavArun Abhayraj Yadav
Site Engineer at Vitrag Infra ProjectsSite Engineer at Vitrag Infra Projects
SHALINI IYERSHALINI IYER
Human Resource & Administration Manager at Oriano Clean Energy Pvt. Ltd. & Its Division RevourHuman Resource & Administration Manager at Oriano Clean Energy Pvt. Ltd. & Its Division Revour