VM Ware, Epic, Athena, Next Gen, Allscript, MDIV & Imagine software
Open To Work
Sreejith Mani Nair
US Healthcare - Denial Management
Dombivli - East
Summary
Healthcare revenue cycle management leader with over 11 years of experience in operations-focused roles. Expertise in driving accounts receivable performance, denial management, and optimizing large-team operations. Proven ability to enhance productivity, strengthen SLA governance, and boost client satisfaction through strategic process improvements.
Overview
4
4
Languages
6
6
Certifications
16
16
years of professional experience
Work History
Sr. Team Leader
Eclat Healthcare Pvt. Ltd.
03.2025 - Current
- End-to-End Oversight: Managing the full AR cycle — from charge entry and claim submission to payment posting, follow-up, and denial resolution.
- Performance Optimization: Monitoring KPIs such as productivity, Average Handling Time (AHT), quality, and utilization to ensure targets are consistently met.
- SLA Compliance: Ensuring all processes adhere to client-defined timelines and service standards.
- One-on-One Coaching: Conducting regular sessions with team members to provide personalized feedback, address performance gaps, and align individual goals with organizational objectives.
- Invoice Preparation: Overseeing accurate and timely preparation of invoices, validating billing data, and ensuring compliance with financial standards to minimize discrepancies.
- Client Escalation Management: Acting as the primary point of contact for client concerns, ensuring quick resolution and maintaining strong relationships.
- Process Improvement: Identifying workflow inefficiencies and implementing corrective measures, often leveraging Lean or Six Sigma methodologies.
- Governance & Reporting: Conducting structured reviews, performance calibrations, and preparing leadership dashboards for transparency and decision-making.
Sr. Team Leader
Access Healthcare Pvt. Ltd.
06.2023 - 02.2025
- Led end-to-end Accounts Receivable (AR) operations for US healthcare providers, ensuring timely reimbursement and reduction in aging inventory.
- Managed a team of AR callers, senior associates, and SMEs handling physician and hospital billing accounts across multiple specialties.
- Monitored daily productivity, quality, denial trends, and KPI performance including AR aging, collection ratio, denial rate, and cash flow improvement.
- Handled escalation management for complex denials, underpayments, appeals, and payer-related issues with Medicare, Medicaid, and commercial insurance carriers.
- Conducted regular audits, feedback sessions, and process trainings to improve team accuracy, compliance, and operational efficiency.
- Prepared and analyzed MIS reports, dashboards, and client performance reviews to identify revenue leakage and process improvement opportunities.
- Collaborated with clients, operations managers, and cross-functional teams to achieve SLA targets and maximize collections.
- Implemented workflow optimization strategies that improved team productivity, reduced backlog, and increased first-pass resolution rates.
- Managed hiring, onboarding, mentoring, and performance appraisal activities for AR team members and team leaders.
- Ensured HIPAA compliance, payer guideline adherence, and quality standards across all AR and denial management activities.
- Experienced in handling denial categories such as CO, PR, OA adjustments, authorization denials, medical necessity denials, coding-related denials, and timely filing issues.
- Worked extensively on revenue cycle tools, payer portals, EHR/EMR systems, and client reporting platforms to streamline AR follow-up processes.
Team Leader
R-Tec Systems
12.2019 - 04.2023
- Directed and managed a high-performing AR team responsible for insurance follow-up, denial management, payment posting support, and accounts resolution for physician and hospital billing.
- Drove operational excellence by consistently achieving key performance indicators (KPIs) including productivity, quality, collections, aging reduction, and denial resolution targets.
- Supervised daily workflow allocation, queue management, and claim prioritization to ensure maximum reimbursement and reduced turnaround time.
- Analyzed AR aging reports, denial trends, payer behavior, and collection performance to identify revenue leakage and implement corrective action plans.
- Provided real-time floor support for complex denial scenarios including authorization denials, medical necessity denials, coding edits, timely filing, bundling issues, and underpayments.
- Conducted performance reviews, quality audits, calibration sessions, and structured feedback meetings to enhance team efficiency and accuracy.
- Mentored and coached AR associates on payer policies, escalation handling, negotiation techniques, and effective collection strategies.
- Collaborated with Operations Managers, Quality Analysts, Clients, and Cross-functional Teams to improve operational metrics and client satisfaction.
- Managed team attendance, shrinkage, attrition control, roster planning, and employee engagement initiatives to maintain operational stability.
- Ensured strict adherence to HIPAA compliance, client SOPs, payer regulations, and internal quality standards across all operational activities.
- Played a key role in process improvement initiatives, workflow automation, backlog reduction, and productivity enhancement projects.
- Successfully improved collection ratios, minimized AR days, reduced denial percentage, and enhanced overall revenue cycle performance through strategic team management.
Sr. Team Leader
INFINX Health Services
12.2012 - 01.2017
- Managing daily RCM processes such as charge entry, claim submission, payment posting, AR follow-up, and denial management.
- Leading senior, team coach, AR specialists and trainees, ensuring productivity and accuracy
- Acting as the point of contact for clients, addressing concerns and ensuring service quality.
- Ensuring adherence to HIPAA, payer guidelines, and internal quality standards.
- Support process improvements, automation, and efficiency initiatives to reduce denials and improve collections.
Sr. AR Associate
Ge-BBS Healthcare Solutions
07.2010 - 12.2012
- Managed end-to-end Accounts Receivable (AR) follow-up with insurance companies to ensure timely claim resolution and reimbursement.
- Handled complex denials and appeals, preparing documentation and resubmitting claims to maximize collections.
- Monitored and analyzed AR aging reports, highlighting high-risk accounts and reducing outstanding balances.
- Ensured strict compliance with HIPAA and payer regulations, maintaining accuracy and confidentiality in all processes
- Collaborated with billing and coding teams to identify root causes of denials and implement corrective actions.
- Maintained detailed records of payer communication and claim status for transparency and audit readiness.
- Mentored junior AR associates, offering guidance on complex cases and best practices.
- Contributed to process improvement initiatives, reducing AR days and enhancing operational efficiency.
Education
Higher Secondary Certificate (HSC) -
Maharashtra Board
01.2004
Secondary School Certificate (SSC) - undefined
Maharashtra Board
01.2002
Skills
MS Office (Excel, Word, PowerPoint)
Tally 90
Certification
Operations Management Course
Software
Work Preference
Job Search Status
Open to workWork Type
Full TimeLocation Preference
On-SiteRemoteHybridSalary Range
₹45000/yr - ₹200000/yrTimeline
Completed: 2026
02-2026
Operations Management Course
08-2025
Sr. Team Leader
Eclat Healthcare Pvt. Ltd.
03.2025 - Current
Sr. Team Leader
Access Healthcare Pvt. Ltd.
06.2023 - 02.2025
Team Leader
R-Tec Systems
12.2019 - 04.2023
Sr. Team Leader
INFINX Health Services
12.2012 - 01.2017
Sr. AR Associate
Ge-BBS Healthcare Solutions
07.2010 - 12.2012
Secondary School Certificate (SSC) - undefined
Maharashtra Board
Higher Secondary Certificate (HSC) -
Maharashtra Board