Shiva Srinivas
Hyderabad
Summary
Dedicated and results-driven Quality specialist with [8 years] of experience in Revenue Cycle Management (RCM). Proven track record of improving operational efficiency, reducing errors, and optimizing revenue performance through data analysis and process improvement initiatives. Seeking to leverage expertise in quality assurance and RCM to drive continuous improvement and deliver superior financial outcomes at R1 RCM
Overview
9
9
years of professional experience
Work History
Quality Specialist(Process Excellence Team)- Revenue Cycle Management
R1 RCM Global Private Limited
05.2021 - Current
- Presently engaged in auditing activities for the Appeals, Regular AR follow up, EMR and Eligibility verification Teams
- Analyze healthcare data to identify trends, patterns, and opportunities for quality improvement initiatives
- Develop and implement quality assurance strategies to ensure compliance with regulatory standards and best practices
- Collaborate with cross-functional teams to design and execute quality improvement projects aimed at enhancing patient care and operational efficiency
- Conduct root cause analysis and risk assessments to mitigate potential quality issues and improve patient safety
- Prepare and present reports on quality metrics, performance indicators, and improvement initiatives to senior management and stakeholders
- Facilitate training sessions and workshops to educate staff on quality improvement methodologies and tools
- Administering monthly PKT questionnaires for the Service delivery teams
- Publishing rework audit percentages, weekly insights, and providing smart observations on trends.
Senior Associate Quality - Revenue Cycle Management
Sutherland Healthcare Solutions
06.2016 - 04.2021
- Joined Sutherland as an Associate, successfully cleared the Internal Job Posting (IJP) process, and advanced to the role of Senior Quality Analyst
- Conducted audits for the Accounts Receivable (AR) and Credentialing Specialist processes
- Transfer the outstanding balance to the patient if he/she doesn't have adequate insurance coverage
- Validating the information through CAQH Site/NPPES and Verify the physician professional license and legal certification information
- Mentored the team to effectively work towards and achieve individual targets.
Education
Bachelor's Degree -
Bhavans Vivekananda Degree College
Intermediate Certificate -
Sri Chaitanya Junior College
Secondary School Certificate (SSC) -
Sri Nagarjuna Vidhyalaya High School
01.2011
Skills
- Promoted to Senior Associate through the Internal Career Progression (ICP) program
- Recognized with the "Certificate of Best Customer Service of the Year" award
- Received the "Certificate of Excellence Star of the Month" award
- Granted the "Certificate of Excellence Special Recognition" accolade
- Recognized by senior managers and stakeholders for consistently delivering excellence in service quality and actively contributing to process improvement initiatives
- Hardworking and self-motivated individual
- Eager and quick to learn new concepts
- Discipline and punctuality
- Enthusiastic about acquiring knowledge in emerging technologies
Languages
English, Hindi, and Telugu
Personal Information
- Father's Name: K. Govind Raju
- Mother's Name: K. Vara Laxmi
- Date of Birth: 01/15/1996
- Gender: Male
- Nationality: Indian
- Marital Status: Single
Skillsprofile
Windows, Proficient in Microsoft Office suite (Excel, Word, PowerPoint), SDLC models.
Hobbies and Interests
Listening to music, traveling, and cooking
Disclaimer
I hereby declare that the details furnished above are true to the best of my knowledge (Kangella Shiva Srinivas)
Timeline
Quality Specialist(Process Excellence Team)- Revenue Cycle Management
R1 RCM Global Private Limited
05.2021 - Current
Senior Associate Quality - Revenue Cycle Management
Sutherland Healthcare Solutions
06.2016 - 04.2021
Bachelor's Degree -
Bhavans Vivekananda Degree College
Intermediate Certificate -
Sri Chaitanya Junior College
Secondary School Certificate (SSC) -
Sri Nagarjuna Vidhyalaya High School
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