Ronak Panchal

Revenue Cycle Management & Strategic Analysis

End-to-End Billing Oversight: Execute comprehensive analysis and review of pre-bill claims (UB-04) to ensure coding accuracy and clinical documentation integrity.
Denial Management & Resolution: Generate and analyze weekly denial reports, spearheading the follow-up on critical claims exceeding $10K to maximize high-value recovery.

Audit & Rebuttals: Manage the full lifecycle of internal and external audits, crafting technical rebuttals against payer remarks to successfully overturn claim denials.

Payer Relations: Compile monthly Payer Escalation Reports and manually secure bulk ERAs to accelerate payment posting cycles and improve cash flow.

Operational Leadership & Team Management

Workflow Optimization: Strategically assign daily workloads based on claim value thresholds ($1K to $10K+) to ensure team focus remains on high-priority revenue.

Team Development: Serve as the primary point of contact for on-floor query resolution, providing technical guidance to Trainees, Senior Executives, and Assistant Managers.

Performance Tracking: Monitor team productivity and output, delivering monthly reports that identify bottlenecks and celebrate high performance.

Cross-Functional Collaboration: Facilitate inter-team communications to drive process improvements across Charge Posting, Eligibility/Benefit Verification, and Payment Posting.

Account Maintenance & Client Communication

Portfolio Health: Conduct monthly reviews of credit balances and track "snoozed" claims to ensure no revenue is left unaddressed.

Client Advocacy: Act as the lead liaison for client inquiries, providing detailed resolutions for specific patient accounts and complex payer queries.

Clearinghouse Management: Monitor and resolve weekly rejected cases at the clearinghouse level to maintain a high "clean claim" submission rate.

• Providing fundamental training to the trainees.
• Running client queries and providing resolution towards those queries.
• Assigning work to the team and providing assistance for complicated cases.
• Performing pre-call analysis and checking status by calling the payer or using IVR or web portal services.
• Maintaining adequate documentation on the client software to send necessary documentation to insurance companies and maintaining a clear audit trail for future reference.
• Recording after-call actions and performing post-call analysis for the claim follow-up.
• Assessing and resolving enquiries, requests, and complaints through calling to ensure that customer enquiries are resolved at the first point of contact.
• Providing accurate service information to customers, researching available documentation including authorization, MAR nurse notes, medical documentation on client's systems, interpret explanation of benefits received, etc. prior to making the call.
• Performing analysis of accounts receivable data and understanding the reasons for underpayment, days in A/R, top denial reasons, using appropriate codes to be used in documentation of the reasons for denials / underpayments.
• Providing training sessions to the team for weekly updates and trending denials.

• Filed Secondary claims.
• Managed Denials - Worked on Primary/Secondary Rejected claims.
• Submitted Reconsideration, Dispute, Level-1 & 2 appeals to the payer.
• Called Payer and got claims reprocessed which were incorrectly denied.
• Provided basic fundamental training to new joiners.
• Assigned open client queries to responsible individuals.
• Prepared a spreadsheet of trending denials and Escalated to seniors for quick resolution.
• Updated Correspondence notes in PMS.
• Worked on Correspondence sent to the provider

• Maintenance of Rolls Royce makes Allen Marine Engines, Turbocharger, Oil bath filter, Fuel Pumps,
• Fuel Injectors and other equipment.
• Maintenance of Booster shade Gate Valves and Strainers.
• Maintenance of Tank farm Sterar Motors, Body valve & Manifolds.
• Scrapper launching barrel. (Pig Launching)
• Calibration of Fuel injectors.
• Overhauling & Maintenance of engines and air compressors.