SANTHOSH KUMAR
Tiruvallur
Summary
Revenue Cycle professional with 2+ years of experience in claims management, denial resolution, and patient communication. Resolves 50+ claims daily with a 60–70% recovery rate while ensuring HIPAA compliance. Skilled in EOB analysis, AR workflows, and cross-functional coordination to accelerate reimbursements.
Overview
2
2
years of professional experience
4
4
years of post-secondary education
Work History
Customer Service Specialist
Omega Healthcare
Chennai
02.2025 - 04.2026
- Managed 50–80 patient and payer emails daily, maintaining a 24–48 hour response SLA for billing and claims inquiries across high-volume queues.
- Reduced patient escalations by coordinating directly with AR and billing departments to resolve complex claim disputes before they impacted revenue cycle timelines.
- Reviewed EOB documentation for 100+ accounts monthly, providing accurate claim status updates and initiating corrective actions to recover delayed reimbursements.
- Maintained 100% HIPAA-compliant documentation across all email correspondence, passing internal compliance audits with zero violations.
- Supported revenue cycle efficiency by identifying recurring payer denial patterns and flagging systemic issues to the billing team for process improvement.
Process Executive – Accounts Receivable
Omega Healthcare
Chennai
01.2024 - 01.2025
- Processed 50+ insurance claims daily, following up with payers via phone and email to resolve denials and rejections with a 60–70% recovery rate.
- Verified patient insurance coverage, eligibility, and benefits across multiple payers to ensure accurate billing and prevent claim rejections at submission.
- Analyzed EOBs and remittance advices to identify billing discrepancies, reducing rework time by implementing targeted corrective actions on high-denial claim categories.
- Escalated unresolved payer issues through structured follow-up protocols, ensuring no claim aged beyond internal SLA thresholds without active action.
- Contributed to process documentation efforts, helping standardize denial management workflows adopted across the AR team.
Education
Bachelor of Computer Application -
Alpha Arts and Science College
Chennai 09.2020 - 06.2023
Higher Secondary Certificate -
St. John's Matriculation Higher Secondary School
Chennai 06.2019 - 05.2020
Skills
- RCM Tools: Waystar, Availity
- EOB & Remittance Analysis
- Customer service support
- Professional email communication
- Insurance Eligibility Verification
- Time management
- Billing Discrepancy Resolution
- Cross-functional Collaboration
Timeline
Customer Service Specialist
Omega Healthcare
02.2025 - 04.2026
Process Executive – Accounts Receivable
Omega Healthcare
01.2024 - 01.2025
Bachelor of Computer Application -
Alpha Arts and Science College
09.2020 - 06.2023
Higher Secondary Certificate -
St. John's Matriculation Higher Secondary School
06.2019 - 05.2020