ROHIT KUMAR
D - 25, Noida sector 15, Gautam Buddh Nagar, U.P.
Summary
I have nearly four years of experience in US RCM Medical billing, specializing in AR denial management and follow up, I am also an effective collaborator and a strong team player. It would be my Endeavour to work in an organization which makes greatest use of my potential, while allowing it to grow with it, both personally and professionally. I would like to excel in different functional areas to prove my worth to the organization.
Overview
4
4
years of professional experience
3
3
years of post-secondary education
1
1
Certification
Work History
Senior Executive
Corro Health Infotech Pvt. Ltd.
Noida
09.2024 - Current
- Resolve high dollar denied claims quickly within required timeframes to ensure steady payment flow.
- Apply expert knowledge of California healthcare models, specifically working with IPA and CAP carriers.
- Perform daily audits on team appeals to ensure all necessary documents, such as Medical Records and EOBs, are correctly attached.
- Verify documentation accuracy to prevent delays and ensure every appeal is complete before submission.
- Educate the team on which medical records are needed for different types of appeals to improve accuracy.
- Provide one-on-one feedback to teammates to help them fix common mistakes and improve their performance.
- Lead training sessions via Microsoft Teams on how to write effective appeal letters and share meeting summaries via email.
- Provide updates in daily review meeting related appeal progress and send detailed audit reports to management for review.
- Identify workflow trends and offer hands - on support to the team to help everyone meet their daily production goals.
Senior Account receivable Associate
Getix Health
Noida
07.2023 - 08.2024
- Resolve Denied Claims: Proactively follow up on unpaid and denied claims to secure accurate payments and maintain a steady cash flow.
- Challenge Incorrect Denials: Contact insurance carriers to discuss and dispute unnecessary denials, successfully pushing for claims to be reprocessed and paid.
- Prioritize High-Dollar Claims: Focus on resolving high-value denied claims first to maximize revenue and reduce the total amount of outstanding debt.
- Route Claims for Resolution: Analyze the root cause of every denial and ensure each claim is routed through the correct steps to reach a final, successful resolution.
- Communicate with Payers: Maintain professional communication with insurance representatives to clarify billing issues and resolve disputes over unpaid services.
- Stay Updated on RCM Trends: Regularly learn and apply the latest Revenue Cycle Management (RCM) updates and insurance policy changes to handle new denial patterns effectively.
Senior Executive
Pacific Bpo Pvt. Ltd.
Noida
10.2022 - 07.2023
- Expertly use both online insurance portals and direct phone calls to investigate denial reasons and secure accurate claim payments.
- Identify common patterns in unpaid claims and share these findings with the team to improve overall production and efficiency.
- Consistently move outstanding Accounts Receivable (AR) toward resolution by ensuring every denied claim is followed up on until paid.
- Provide strategic support to team members by finding faster ways to resolve claims, helping the entire department meet its daily goals.
- Proactively learn new RCM updates and master various insurance tools to stay highly effective at resolving complex denial scenarios.
Claim Analyst
Rubixis Technologies Pvt. Ltd.
Delhi
05.2022 - 10.2022
- Mastered the use of various insurance portals and direct telephonic communication to investigate denial reasons and secure accurate claim payments.
- Take full ownership of the accounts receivable portfolio by diligently following up on all unpaid and denied claims to ensure a steady flow of revenue.
- Regularly conduct professional inquiries with insurance carriers to clarify claim status of billed claims.
- Focus on understanding the specific logic behind each denial to implement the correct solution and prevent recurring billing errors.
- Dedicated to achieving high-performance standards in Revenue Cycle Management (RCM) by staying current with industry updates and continuously improving resolution techniques.
Education
Bachelor of Arts - Home Science
Lalit Narayan Mithila University
Darbhanga, Bihar, India 05.2019 - 03.2022
Skills
- Claims resolution
- Denial management
- Revenue cycle management
- Appeals processing
- Good communication
- Positive Attitude
- Basic in computer
- Working knowledge of MS - Excel, MS - Word, Tableau
- Worked on PMS - Meditech, Cerner, Quadax, Epic
- Team player
Certification
Completed the certifications listed below through GuruCool Learning with support of my Organization, Corro health.
. Spoken English: indianism
. Stress Management
. The power of listening
. Building a stronger you
. Meeting Etiquette
Timeline
Senior Executive
Corro Health Infotech Pvt. Ltd.
09.2024 - Current
Senior Account receivable Associate
Getix Health
07.2023 - 08.2024
Senior Executive
Pacific Bpo Pvt. Ltd.
10.2022 - 07.2023
Claim Analyst
Rubixis Technologies Pvt. Ltd.
05.2022 - 10.2022
Bachelor of Arts - Home Science
Lalit Narayan Mithila University
05.2019 - 03.2022