Summary
Overview
Work History
Education
Skills
Languages
Core Competencies
Timeline
Generic

Sakshi Rathi

Durgapur

Summary

Healthcare administration professional with expertise in revenue cycle management. Demonstrated proficiency in authorization, referral, claim processing, and appeals, leading to improved billing accuracy and reduced denials. Skilled in managing insurance follow-ups and optimizing account receivables, resulting in maximized revenue collection. Strong ability to create efficient workflows and streamline operations for enhanced team performance.

Overview

6
6
years of professional experience

Work History

Senior Analyst – 3

Finthrive India Pvt. Ltd.
Gurugram
05.2024 - Current
  • Manage denial resolution by analyzing trends, identifying root causes, and resubmitting claims.
  • Recover underpayments by investigating discrepancies, reviewing payer contracts, and submitting appeals.
  • Resolve $0 or dead claims with thorough documentation and escalation.
  • Ensure compliance with payer guidelines and maintain accurate claim resolution records.

Senior Associate - 2

OneMed Billing
Kolkata
09.2023 - 04.2024
  • Claim Submission: Efficiently submit accurate claims for timely processing and reimbursement.
  • Denial Management: Quickly address and resolve claim denials to ensure smooth financial workflows.
  • Create Authorization & Referrals: Facilitate authorizations and referrals to streamline patient care and billing processes.
  • Follow Up with Insurance for Payments on Denied Claims: Actively communicate with insurers to secure payments for initially denied claims.

Senior Associate - 1

Wipro Ltd.
Kolkata
10.2019 - 05.2023
  • Spearheaded the authorization process, ensuring timely approvals and accurate documentation for medical services while also providing detailed benefit breakdowns and claim status updates to providers.
  • Excelled in Accounts Receivable (AR) management, consistently following up on payments to improve cash flow.
  • Outstanding Demonstrated expertise in eligibility verification and benefit assessment, optimizing reimbursement processes for healthcare services.
  • Managed dead inventories effectively, analyzing payment versus contracted rates to identify variances and work towards getting the payment.
  • Proficient in denial management, actively identifying and addressing claim denials to minimize revenue loss and improve reimbursement rates.

Education

Bachelor of Commerce (B.Com.) Hons. - Accounts & Finance

BGES
Kolkata
01.2019

Skills

  • Analytical
  • Collaborator
  • Communication
  • Adaptable
  • Denial management
  • Problem solving
  • Communication skills
  • Electronic Health Record (EHR) for patient record management and data analysis
  • Healthcare data security and privacy: understanding data security protocols, patient privacy regulations (eg HIPAA and best practices to protect sensitive financial and health information)

Languages

Languages Known: English, Hindi and Bengali

Core Competencies

  • Denial Management
  • Patient Financial Services
  • Compliance & Regulatory Knowledge
  • Billing Accuracy
  • Financial Analysis

Timeline

Senior Analyst – 3

Finthrive India Pvt. Ltd.
05.2024 - Current

Senior Associate - 2

OneMed Billing
09.2023 - 04.2024

Senior Associate - 1

Wipro Ltd.
10.2019 - 05.2023

Bachelor of Commerce (B.Com.) Hons. - Accounts & Finance

BGES

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Sakshi Rathi