Sugumaran P L
Certified Profesional Biller
ChennI
Summary
Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors. Confident Medical Biller knowledgeable in data confidentiality and privacy practices when reviewing patient information. Competent RCM with 10+years of experience in handling wide variety of medical coding and billing tasks. Sophisticated and hardworking individual with excellent analytical and multitasking abilities. Coordinates with insurance companies and expedites claims processes. Expertise in accurately inputting procedure and diagnosis codes into billing software to generate invoices.
Overview
11
11
years of professional experience
5
5
years of post-secondary education
1
1
Certification
Work History
Manager RCM
SCIO Management
Chennai
03.2012 - Current
- Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Monitored and guided revenue cycle operations.
- Supported clinical team members with revenue cycle procedures and addressed issues.
- Completed financial reporting and analysis for billing revenue cycle.
- Identified discrepancies between budgetary targets and actual revenue and expenses.
- Assessed current revenue cycle procedures and implemented improvements to foster efficiency.
- Prepared cash flow projections, cost analysis and monthly, quarterly and annual reports.
- Designed and maintained financial models to identify and measure risks.
- Analyzed care plans and upheld JCAHO, Medicare and Medicaid guidelines.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Delivered timely and accurate charge submissions.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted payments and collections on regular basis.
- Liaised between patients, insurance companies, and billing office.
- Collected payments and applied to patient accounts.
- Filed and updated patient information and medical records.
- Adhered to established standards to safeguard patients' health information.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Generated reports and analyzed trends to maximize reimbursement and reduce claim denials.
- Verified insurance of patients to determine eligibility.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Audited and corrected billing and posting documents for accuracy.
- Entered invoices requiring payment and disbursed amounts via check, electronic transfer or bank draft.
- Kept vendor files accurate and up-to-date to expedite payment processing.
- Responded to customer concerns and questions on daily basis.
- Verified accuracy of accounts payable payments, resulting in 100% reduction in payment errors and check reissues.
- Learned and adapted quickly to new technology and software applications.
- Generated monthly billing and posting reports for management review.
Education
Bachelor Of Computer Applications - Computer Science
Madras University
Chennai 06.2008 - 04.2010
DCE - Computer Engineering
Sriram Polytechnic College
Chennai 06.2005 - 04.2008
Skills
Accounts receivable management
Medical record security
Medicare and Medicaid process
Payment posting
Patient account analysis
[Specialization] billing knowledge
Medical coding knowledge
Records Maintenance
Medical terminology expert
Medical claims submission
Data analysis
Database Management
Financial Management
Accounting systems and controls
Quality Assurance Management
Regulatory filings
Billing statement review
Management accounting
Cash Flow analysis
Accounting remittances
A/P and A/R expertise
Proficiency in [Software]
Certification
Licensed [CPB] - AAPC
Timeline
Licensed [CPB] - AAPC
05-2023
Manager RCM
SCIO Management
03.2012 - Current
Bachelor Of Computer Applications - Computer Science
Madras University
06.2008 - 04.2010
DCE - Computer Engineering
Sriram Polytechnic College
06.2005 - 04.2008