Sameer Jadhav
Ulwe
Summary
With over two decades of experience in the healthcare claims processing and medical billing industry, my career began in 2001 as a Data Processor at Innet India Pvt Ltd. I have steadily progressed within the organization, acquiring extensive expertise across various processes and departments. This journey has allowed me to master essential functions including proofreading, claim validation, clearinghouse rejections, accounts receivable (AR) management, client support, denial management, medical coding (ICD-10), and client reporting & analysis. Alongside my technical skills, I have successfully led teams in roles such as Training Manager, AVP-Quality, and currently as VP-Operations. As VP-Operations, I focus on driving operational excellence and implementing process improvements throughout the organization.
Overview
24
24
years of professional experience
1
1
Certification
Work History
VP Operations & Research
Claimpower India Pvt Ltd
12.2021 - 03.2025
- Results-driven Vice President of Operations with expertise in medical billing, revenue cycle management (RCM), and process optimization
- Proven ability to streamline workflows, improve claims processing, and enhance AR recovery
- Strong leadership in team management, client relations, and compliance adherence
- Adept at implementing process improvements, training programs, and technology solutions to drive operational excellence
- Managed claims processing, client management, quality assurance, and process improvement for multiple departments
- Spearheaded cost-saving initiatives by implementing technology-driven solutions
- Led cross-functional teams and training programs, improving operational efficiency and compliance
- Optimized charge entry, AR management, payment posting, and denial resolution
- Implemented root cause analysis in denial management, reducing avoidable denials
- Ensured 100% accurate and timely payment processing
- Established Key Responsibility Areas (KRAs) and performance metrics for multiple teams
- Led quality control initiatives, reducing billing errors and increasing revenue recovery
- Reduced cycle times by 89% through workflow optimization across multiple departments
- Lowered claim denial rates by 67% via targeted denial management strategies
- Increased AR recovery by 45% through enhanced follow-up processes and client communication
- Enhanced operational compliance by 94%, ensuring HIPAA and audit adherence
- Developed an employee tracking system to monitor work status and daily tasks, boosting productivity
- Led technology and process improvements, driving cost savings and operational efficiency
AVP Quality Analyst
Innet India Pvt Ltd
09.2001 - 11.2021
- Processed high volumes of healthcare claims, ensuring accuracy and timely submissions
- Improved processing speed and accuracy by identifying common errors and implementing solutions
- Ensured error-free claim submissions, improving approval rates and reducing rejections
- Strengthened claim validation processes, reducing billing errors and improving compliance
- Managed clearinghouse rejections, working with teams to correct and resubmit claims
- Enhanced AR recovery rates by reducing claim aging periods and implementing better follow-up strategies
- Led denial management efforts, analyzing denied claims and implementing corrective actions
- Improved client satisfaction through proactive communication and support
- Ensured accurate ICD-10 coding, reducing claim rejections and audit risks
- Developed client reports and data-driven insights to improve financial decision-making
- Conducted medical record audits, improving documentation quality and reducing compliance risks
- Ensured adherence to internal and external compliance standards, preventing penalties
- Developed and managed training programs on claims processing, denial management, ICD-10 coding, and compliance
- Led process improvements, reducing operational bottlenecks and improving workflow efficiency
- Implemented quality control measures, increasing process adherence by 89%
- Ensured regulatory compliance and industry best practices, enhancing operational accuracy
Education
Higher secondary -
St joseph high school
Bcom -
University of Mumbai IDE
Skills
- Revenue Cycle Management (RCM)
- Claims Processing
- Process Improvement
- Workflow Automation
- Team Leadership
- Performance Management
- Client Relationship Management
- Regulatory Compliance
- HIPAA Adherence
- Denial Management
Certification
- Certified Professional Coder - Harvard
- Harvins Lean Six Sigma Green Belt
- AI/ML tools certified
- Basic SQL online learning
Personal Information
- Date of Birth: 02/12/80
- Gender: Male
- Nationality: Indian
- Marital Status: Married
- Religion: Islam
Timeline
VP Operations & Research
Claimpower India Pvt Ltd
12.2021 - 03.2025
AVP Quality Analyst
Innet India Pvt Ltd
09.2001 - 11.2021
Higher secondary -
St joseph high school
Bcom -
University of Mumbai IDE
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